ROBERT W BRENNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****67

License Status

NOT RENEWED

Business

First Name

ROBERT W

Last Name

BRENNER

Suffix

Business Name

ROBERT W BRENNER MD

Original Issue Date

08/17/1990

Effective Date

08/17/1990

Expiration Date

07/31/1993

City

CHANUTE AIR BASE

State

Zip

61868

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006