BRIAN PATRICK SPROUSE MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067086

License Status

CANCELLED

Business

Title

First Name

BRIAN

Middle

PATRICK

Last Name

SPROUSE

Business Name

BRIAN PATRICK SPROUSE MD

Original Issue Date

06/24/2015

Effective Date

06/24/2015

Expiration Date

06/23/2018

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

06/01/2015