BRUCE R BACON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036081934

License Status

NOT RENEWED

Business

Title

First Name

BRUCE

Middle

Last Name

BACON

Business Name

BRUCE R BACON MD

Original Issue Date

12/14/1990

Effective Date

08/03/2020

Expiration Date

07/31/2023

City

SPRINGFIELD

State

Zip

62704

County

PERRY

Ever Disciplined

LastModifiedDate

11/30/2023