ROBERT TATE BROUILLETTE JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

NOT RENEWED

Business

First Name

ROBERT TATE

Last Name

BROUILLETTE JR

Suffix

Business Name

ROBERT TATE BROUILLETTE JR MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006