PHYLLIS S BREALL Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036089837

License Status

NOT RENEWED

Business

First Name

PHYLLIS S

Last Name

BREALL

Business Name

PHYLLIS S BREALL

Original Issue Date

10/18/1994

Effective Date

10/18/1994

Expiration Date

07/31/2002

City

PORTLAND

State

Zip

97201

County

OREGON

Ever Disciplined

LastModifiedDate

10/09/2006