BROCKTON L WEISENBERGER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

NOT RENEWED

Business

First Name

BROCKTON L

Last Name

WEISENBERGER

Suffix

Business Name

BROCKTON L WEISENBERGER MD

Original Issue Date

12/05/1983

Effective Date

12/05/1983

Expiration Date

07/31/1996

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006