MICHAEL LEROY BRUIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036102870

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

LEROY

Last Name

BRUIN

Suffix

Business Name

MICHAEL LEROY BRUIN MD

Original Issue Date

06/27/2000

Effective Date

04/07/2020

Expiration Date

09/30/2020

City

EFFINGHAM

State

Zip

62401

County

EFFINGHAM

Ever Disciplined

LastModifiedDate

12/28/2023