BRETT FREDERICK PLOUSSARD DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125080866

License Status

CANCELLED

Business

Title

First Name

BRETT

Middle

FREDERICK

Last Name

PLOUSSARD

Business Name

BRETT FREDERICK PLOUSSARD DO

Original Issue Date

07/01/2022

Effective Date

07/01/2022

Expiration Date

06/30/2025

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

01/07/2025