BRUCE A BLACKER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****60

License Status

ACTIVE

Business

First Name

BRUCE A

Last Name

BLACKER

Suffix

Business Name

BRUCE A BLACKER MD

Original Issue Date

05/13/1986

Effective Date

06/23/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/23/2023