DAVID RANDALL BRUCE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

First Name

DAVID RANDALL

Last Name

BRUCE

Business Name

DAVID RANDALL BRUCE

Original Issue Date

09/18/1990

Effective Date

09/18/1990

Expiration Date

07/31/2002

City

DIXON

State

Zip

61021

County

LEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020