BRENTON CHARLES BOHLIG MD 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

Title

First Name

BRENTON

Middle

CHARLES

Last Name

BOHLIG

Business Name

BRENTON CHARLES BOHLIG MD

Original Issue Date

07/17/2018

Effective Date

07/17/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021