BROOKE AUTUMN KONZ MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070534

License Status

EXPIRED

Business

Title

First Name

BROOKE

Middle

AUTUMN

Last Name

KONZ

Business Name

BROOKE AUTUMN KONZ MD

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2020

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

11/19/2020