BRUCE E BROCKSTEIN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

ACTIVE

Business

First Name

BRUCE E

Last Name

BROCKSTEIN

Suffix

Business Name

BRUCE E BROCKSTEIN MD

Original Issue Date

08/12/1993

Effective Date

07/03/2023

Expiration Date

07/31/2026

City

EVANSTON

State

Zip

60201

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/03/2023