NOLAN BROUSSARD MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125080535

License Status

CANCELLED

Business

Title

First Name

NOLAN

Last Name

BROUSSARD

Business Name

NOLAN BROUSSARD MD

Original Issue Date

07/01/2022

Effective Date

07/01/2022

Expiration Date

06/30/2024

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

05/09/2022