CHARLES B BRUYNTJENS JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****45

License Status

NOT RENEWED

Business

First Name

CHARLES

Middle

Last Name

BRUYNTJENS

Suffix

JR MD

Business Name

CHARLES B BRUYNTJENS JR MD

Original Issue Date

08/25/1986

Effective Date

08/25/1986

Expiration Date

07/31/1993

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020