BRIAN LEE ABBOTT Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000434

License Status

EXPIRED

Business

First Name

BRIAN

Middle

LEE

Last Name

ABBOTT

Business Name

BRIAN LEE ABBOTT

Original Issue Date

10/03/1997

Effective Date

10/03/1997

Expiration Date

10/02/1999

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/25/2006