License holder summary

KEVEN D BROCKBANK is a Physician - Physician & Surgeon licensed to practice in Utah. The address on file for KEVEN D BROCKBANK is SALT LAKE CITY, UT 841232884. This licensed professional license is not current. The license was granted 06/26/1984 and expired on 03/22/2005.

Utah

Division of Occupational and Professional Licensing

KEVEN D BROCKBANK
Physician - Physician & Surgeon
License number
171379-1205
Date granted
06/26/1984
Date expires
03/22/2005
Class
Physician - Physician & Surgeon
Status
Surrendered
Address
SALT LAKE CITY, UT 841232884
utahlicensing.org
ID 29928174
LAST UPDATED 2026-03-17 11:58:21 UTC

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