VALERIE MOORE BROSTROM MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055335

License Status

CANCELLED

Business

Title

First Name

VALERIE

Middle

MOORE

Last Name

BROSTROM

Business Name

VALERIE MOORE BROSTROM MD

Original Issue Date

07/01/2008

Effective Date

07/01/2008

Expiration Date

06/30/2011

City

CHICAGO

State

Zip

60641

County

COOK

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

06/04/2008