BROCK WILLIAM PEIFFER DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125072369

License Status

CANCELLED

Business

Title

First Name

BROCK

Middle

WILLIAM

Last Name

PEIFFER

Business Name

BROCK WILLIAM PEIFFER DO

Original Issue Date

07/18/2019

Effective Date

07/18/2019

Expiration Date

07/17/2021

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

07/18/2019