BRYCE TYLER DE VENECIA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

ACTIVE

Business

Title

First Name

BRYCE

Middle

TYLER

Last Name

DE VENECIA

Business Name

BRYCE TYLER DE VENECIA MD

Original Issue Date

07/15/2023

Effective Date

07/15/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/15/2023