CARLY SUE KRUSE 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

Title

First Name

CARLY

Middle

SUE

Last Name

KRUSE

Business Name

CARLY SUE KRUSE MD

Original Issue Date

06/07/2021

Effective Date

07/06/2023

Expiration Date

07/31/2026

City

ROCKFORD

State

Zip

61102

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/06/2023