BRUCE CHARLES LARSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

NOT RENEWED

Business

First Name

BRUCE CHARLES

Last Name

LARSON

Suffix

Business Name

BRUCE CHARLES LARSON MD

Original Issue Date

01/08/1986

Effective Date

01/08/1986

Expiration Date

07/31/1996

City

BURBANK

State

Zip

60459

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020