BRYCE JAHNOTHAN BRAAKSMA DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

NOT RENEWED

Business

Title

First Name

BRYCE

Middle

JAHNOTHAN

Last Name

BRAAKSMA

Business Name

BRYCE JAHNOTHAN BRAAKSMA DO

Original Issue Date

05/17/2017

Effective Date

05/17/2017

Expiration Date

09/30/2020

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

01/14/2021