DANIEL BLAISE BRUZZINI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

ACTIVE

Business

Title

First Name

DANIEL

Middle

BLAISE

Last Name

BRUZZINI

Business Name

DANIEL BLAISE BRUZZINI MD

Original Issue Date

05/04/2015

Effective Date

07/15/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61636

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/15/2023