BLAKELYN BUSSE DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

ACTIVE

Business

Title

First Name

BLAKELYN

Last Name

BUSSE

Business Name

BLAKELYN BUSSE DO

Original Issue Date

03/08/2022

Effective Date

07/06/2023

Expiration Date

07/31/2026

City

SHILOH

State

Zip

62221

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/04/2024