BURT IRVIN BROMBERG MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036082542

License Status

INACTIVE

Business

First Name

BURT IRVIN

Last Name

BROMBERG

Suffix

Business Name

BURT IRVIN BROMBERG MD

Original Issue Date

06/05/1991

Effective Date

06/15/2011

Expiration Date

07/31/2014

City

SAINT LOUIS

State

Zip

63141

County

MISSOURI

Ever Disciplined

LastModifiedDate

04/08/2014