GARRY BRETT MOUNTAIN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000548

License Status

EXPIRED

Business

First Name

GARRY

Middle

BRETT

Last Name

MOUNTAIN

Suffix

Business Name

GARRY BRETT MOUNTAIN MD

Original Issue Date

04/01/2002

Effective Date

04/01/2002

Expiration Date

04/30/2002

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

09/25/2006