BERT RUSSELL BROCKWAY Respiratory Care Practitioner License verification

Business Entity

NOT RENEWED

License Type

Respiratory Care Practitioner

Description

RESPIRATORY CARE PRACTITIONER

License Number

194005153

License Status

NOT RENEWED

Business

First Name

BERT

Middle

RUSSELL

Last Name

BROCKWAY

Business Name

BERT RUSSELL BROCKWAY

Original Issue Date

07/29/2002

Effective Date

10/28/2009

Expiration Date

10/31/2011

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

12/07/2011