BROCK ANDREW HARDIN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067613

License Status

EXPIRED

Business

Title

First Name

BROCK

Middle

ANDREW

Last Name

HARDIN

Business Name

BROCK ANDREW HARDIN MD

Original Issue Date

06/25/2018

Effective Date

06/25/2018

Expiration Date

07/22/2018

City

PARK RIDGE

State

Zip

60068

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

12/04/2018