BRIAN JOHN CARROLL DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125064529

License Status

CANCELLED

Business

Title

First Name

BRIAN

Middle

JOHN

Last Name

CARROLL

Business Name

BRIAN JOHN CARROLL DO

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2018

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Obstetrics and Gynecology

Ever Disciplined

LastModifiedDate

05/11/2017