BROCK DAVID ANDREATTA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054361

License Status

CANCELLED

Business

Title

First Name

BROCK

Middle

DAVID

Last Name

ANDREATTA

Business Name

BROCK DAVID ANDREATTA MD

Original Issue Date

07/01/2008

Effective Date

07/01/2008

Expiration Date

06/30/2011

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

05/19/2008