ANDREW S BRENNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

First Name

ANDREW S

Last Name

BRENNER

Suffix

Business Name

ANDREW S BRENNER MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2008

City

CHAMPAIGN

State

Zip

61822

County

MACON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008