BRIAN JOSEPH MEDERNACH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052968

License Status

EXPIRED

Business

First Name

BRIAN

Middle

JOSEPH

Last Name

MEDERNACH

Suffix

Business Name

BRIAN JOSEPH MEDERNACH MD

Original Issue Date

06/22/2008

Effective Date

06/22/2008

Expiration Date

06/21/2011

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Internal Medicine/Pediatrics

Ever Disciplined

LastModifiedDate

07/19/2011