BRETT ALAN WURTH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000622

License Status

EXPIRED

Business

First Name

BRETT

Middle

ALAN

Last Name

WURTH

Suffix

Business Name

BRETT ALAN WURTH MD

Original Issue Date

10/18/2004

Effective Date

10/18/2004

Expiration Date

11/17/2004

City

SPRINGFIELD

State

Zip

62712

County

SANGAMON

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/25/2006