KRISTEN INGRID BRUNO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

NOT RENEWED

Business

First Name

KRISTEN

Middle

INGRID

Last Name

BRUNO

Suffix

Business Name

KRISTEN INGRID BRUNO MD

Original Issue Date

04/01/2011

Effective Date

05/19/2014

Expiration Date

07/31/2017

City

MARYVILLE

State

Zip

62062

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017