BROOKE JACLYN KULP DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069207

License Status

EXPIRED

Business

Title

First Name

BROOKE

Middle

JACLYN

Last Name

KULP

Business Name

BROOKE JACLYN KULP DO

Original Issue Date

06/22/2016

Effective Date

06/22/2016

Expiration Date

06/21/2019

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

10/02/2019