KRISTA MICHELLE BRUCKER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036131788

License Status

NOT RENEWED

Business

Title

First Name

KRISTA

Middle

MICHELLE

Last Name

BRUCKER

Business Name

KRISTA MICHELLE BRUCKER MD

Original Issue Date

11/29/2012

Effective Date

11/29/2012

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60622

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014