BRANDON K CONNERLY Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

NOT RENEWED

Business

First Name

BRANDON

Middle

Last Name

CONNERLY

Business Name

BRANDON K CONNERLY

Original Issue Date

05/07/2002

Effective Date

05/07/2002

Expiration Date

07/31/2005

City

OAK PARK

State

Zip

60302

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006