BRUCE C SUMMERVILLE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

ACTIVE

Business

First Name

BRUCE C

Last Name

SUMMERVILLE

Suffix

Business Name

BRUCE C SUMMERVILLE MD

Original Issue Date

06/26/2014

Effective Date

06/10/2023

Expiration Date

07/31/2026

City

LINDENHURST

State

Zip

60046

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/10/2023