BRUCE ALLEN MARSHALL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

First Name

BRUCE

Middle

ALLEN

Last Name

MARSHALL

Suffix

Business Name

BRUCE ALLEN MARSHALL MD

Original Issue Date

06/09/2000

Effective Date

06/24/2014

Expiration Date

07/31/2017

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020