DAVID MALCOLM BRENTNALL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****86

License Status

NOT RENEWED

Business

First Name

DAVID MALCOLM

Last Name

BRENTNALL

Suffix

Business Name

DAVID MALCOLM BRENTNALL MD

Original Issue Date

06/23/1997

Effective Date

06/23/1997

Expiration Date

07/31/2002

City

PETERSBURG

State

Zip

62675

County

MENARD

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006