DUSTIN MARK BROWN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054663

License Status

EXPIRED

Business

First Name

DUSTIN

Middle

MARK

Last Name

BROWN

Business Name

DUSTIN MARK BROWN

Original Issue Date

06/23/2011

Effective Date

06/23/2011

Expiration Date

06/22/2012

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Obstetrics & Gynecology

Ever Disciplined

LastModifiedDate

08/29/2012