H JAY BRUNINGA OD MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****51

License Status

ACTIVE

Business

First Name

H JAY

Last Name

BRUNINGA

Suffix

OD MD

Business Name

H JAY BRUNINGA OD MD

Original Issue Date

11/21/1986

Effective Date

07/11/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/11/2023