MICHAEL DAVID PETRUCCI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****09

License Status

NOT RENEWED

Business

Title

First Name

MICHAEL

Middle

DAVID

Last Name

PETRUCCI

Business Name

MICHAEL DAVID PETRUCCI MD

Original Issue Date

06/14/2012

Effective Date

06/14/2012

Expiration Date

07/31/2014

City

COLORADO SPRINGS

State

Zip

80920

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014