BRENT D REIFSTECK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049157

License Status

EXPIRED

Business

First Name

BRENT

Middle

Last Name

REIFSTECK

Suffix

Business Name

BRENT D REIFSTECK MD

Original Issue Date

07/01/2005

Effective Date

07/01/2005

Expiration Date

06/30/2008

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

07/31/2008