PETER BRUKASZ 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

PETER

Last Name

BRUKASZ

Business Name

PETER BRUKASZ

Original Issue Date

07/13/2004

Effective Date

07/13/2004

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60646

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020