SHANE EDWARD RUCKLE MD 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

SHANE

Middle

EDWARD

Last Name

RUCKLE

Business Name

SHANE EDWARD RUCKLE MD

Original Issue Date

07/14/2024

Effective Date

07/14/2024

Expiration Date

07/31/2026

City

MONMOUTH

State

Zip

61462

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/24/2026