KRISTA MICHELLE BRUCKER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058501

License Status

CANCELLED

Business

Title

First Name

KRISTA

Middle

MICHELLE

Last Name

BRUCKER

Business Name

KRISTA MICHELLE BRUCKER MD

Original Issue Date

06/23/2010

Effective Date

06/23/2010

Expiration Date

06/22/2013

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

04/22/2010