BREANNE ARLENE TRAVIS DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076719

License Status

CANCELLED

Business

Title

First Name

BREANNE

Middle

ARLENE

Last Name

TRAVIS

Business Name

BREANNE ARLENE TRAVIS DO

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2023

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

04/20/2020