BRUCE R TIZES MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125016420

License Status

EXPIRED

Business

First Name

BRUCE R

Last Name

TIZES

Suffix

Business Name

BRUCE R TIZES MD

Original Issue Date

10/12/1983

Effective Date

10/12/1983

Expiration Date

09/01/1985

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006