BRUCE W MILLER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036042403

License Status

NOT RENEWED

Business

First Name

BRUCE W

Last Name

MILLER

Suffix

Business Name

BRUCE W MILLER MD

Original Issue Date

12/20/1968

Effective Date

12/20/1968

Expiration Date

07/31/2005

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

10/09/2006