BRUCE JAY GARDNER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

NOT RENEWED

Business

Title

First Name

BRUCE

Middle

JAY

Last Name

GARDNER

Business Name

BRUCE JAY GARDNER MD

Original Issue Date

06/03/2013

Effective Date

06/27/2014

Expiration Date

07/31/2017

City

ANCHORAGE

State

Zip

99506

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017