RYAN BREDE BUCKNAM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130001300

License Status

EXPIRED

Business

Title

First Name

RYAN

Middle

BREDE

Last Name

BUCKNAM

Business Name

RYAN BREDE BUCKNAM MD

Original Issue Date

07/11/2019

Effective Date

07/11/2019

Expiration Date

09/28/2019

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

01/13/2020