SAMUEL FREDERICK BRUNK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036122856

License Status

NOT RENEWED

Business

Title

First Name

SAMUEL

Middle

FREDERICK

Last Name

BRUNK

Business Name

SAMUEL FREDERICK BRUNK MD

Original Issue Date

03/17/2009

Effective Date

03/17/2009

Expiration Date

07/31/2011

City

SAINT MICHAEL

State

Zip

55376

Ever Disciplined

LastModifiedDate

11/14/2011