ANDREA M BRAULT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

NOT RENEWED

Business

First Name

ANDREA M

Last Name

BRAULT

Suffix

Business Name

ANDREA M BRAULT MD

Original Issue Date

04/16/1997

Effective Date

04/16/1997

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

09/26/2006