STEPHEN P BRACKBILL Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

First Name

STEPHEN

Middle

Last Name

BRACKBILL

Business Name

STEPHEN P BRACKBILL

Original Issue Date

04/10/2002

Effective Date

04/10/2002

Expiration Date

07/31/2005

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006