BRIAN J HETTRICK Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036096994

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

HETTRICK

Business Name

BRIAN J HETTRICK

Original Issue Date

11/14/1997

Effective Date

04/12/2017

Expiration Date

09/30/2020

City

SALEM

State

Zip

53168

County

WISCONSIN

Ever Disciplined

LastModifiedDate

01/14/2021