CHRISTOPHER ANTONIO BRACKSHAW DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130001186

License Status

EXPIRED

Business

Title

First Name

CHRISTOPHER

Middle

ANTONIO

Last Name

BRACKSHAW

Business Name

CHRISTOPHER ANTONIO BRACKSHAW DO

Original Issue Date

11/20/2017

Effective Date

11/20/2017

Expiration Date

12/19/2017

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Geriatric Medicine

Ever Disciplined

LastModifiedDate

04/10/2018