BRENT RICHARD KAUFMANN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125056542

License Status

CANCELLED

Business

Title

First Name

BRENT

Middle

RICHARD

Last Name

KAUFMANN

Business Name

BRENT RICHARD KAUFMANN MD

Original Issue Date

06/26/2010

Effective Date

06/26/2010

Expiration Date

06/25/2012

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

06/10/2010