CHARLES HAROLD BAZUIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

First Name

CHARLES HAROLD

Last Name

BAZUIN

Suffix

Business Name

CHARLES HAROLD BAZUIN MD

Original Issue Date

01/01/1997

Expiration Date

07/31/1987

City

ROCKFORD

State

Zip

61107

County

BOONE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006