BRENTON DANIEL GOODMAN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067501

License Status

EXPIRED

Business

Title

First Name

BRENTON

Middle

DANIEL

Last Name

GOODMAN

Business Name

BRENTON DANIEL GOODMAN MD

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2018

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

10/25/2018