KEVIN BRUCE LAKE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036041444

License Status

NOT RENEWED

Business

First Name

KEVIN BRUCE

Last Name

LAKE

Suffix

Business Name

KEVIN BRUCE LAKE MD

Original Issue Date

11/16/1967

Effective Date

11/16/1967

City

PASADENA

State

Zip

91106

County

CALIFORNIA

Ever Disciplined

LastModifiedDate

09/20/2006