KEVEN D BROCKBANK
Physician - Physician/Surgeon Cs
Utah 171379-8905 Surrendered
This Utah license was held by KEVEN D BROCKBANK. The license is no longer active. It was granted on 06/26/1984 and expired on 03/22/2005
LICENSE DETAILS
- License Number: 171379-8905
- Category: PHYSICIAN/SURGEON CS
- Status: Surrendered
- Date Granted: 06/26/1984 (about 40 years ago)
- Expiry Date: 03/22/2005 (over 19 years ago)
LOCATIONS
A Address
SALT LAKE CITY, UT 841232884