BRIAN EDWARD PUCEVICH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125055612

License Status

EXPIRED

Business

First Name

BRIAN

Middle

EDWARD

Last Name

PUCEVICH

Suffix

Business Name

BRIAN EDWARD PUCEVICH MD

Original Issue Date

07/01/2009

Effective Date

07/01/2009

Expiration Date

06/30/2012

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

08/29/2012