BRENT H UPCHURCH MD

Business Entity
NOT RENEWED

Medical Doctor

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

33*****27

NOT RENEWED

N

BRENT H

UPCHURCH

MD

BRENT H UPCHURCH MD

10/21/1985

10/21/1985

07/31/1990

CHICAGO

IL

60651

COOK

II III IV V

N

09/26/2006