BRUCE R BACON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

Title

First Name

BRUCE

Middle

Last Name

BACON

Business Name

BRUCE R BACON MD

Original Issue Date

12/20/1990

Effective Date

12/20/1990

Expiration Date

07/31/1996

City

DU QUOIN

State

Zip

62832

County

PERRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020