TRAVIS PAUL TENBROCK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125083808

License Status

ACTIVE

Business

Title

First Name

TRAVIS

Middle

PAUL

Last Name

TENBROCK

Business Name

TRAVIS PAUL TENBROCK MD

Original Issue Date

06/25/2024

Effective Date

06/25/2024

Expiration Date

06/24/2027

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

04/04/2024