GEORGE T BRODERICK JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

NOT RENEWED

Business

First Name

GEORGE T

Last Name

BRODERICK JR

Suffix

Business Name

GEORGE T BRODERICK JR MD

Original Issue Date

09/30/1986

Effective Date

09/30/1986

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60632

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006