DAVID ELLIOTT DEBRUIN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052675

License Status

EXPIRED

Business

Title

First Name

DAVID

Middle

ELLIOTT

Last Name

DEBRUIN

Business Name

DAVID ELLIOTT DEBRUIN MD

Original Issue Date

06/23/2007

Effective Date

06/23/2007

Expiration Date

06/22/2008

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Transitional Year

Ever Disciplined

LastModifiedDate

06/26/2008