BRUCE HERBERT WHITLEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

NOT RENEWED

Business

First Name

BRUCE

Middle

HERBERT

Last Name

WHITLEY

Suffix

Business Name

BRUCE HERBERT WHITLEY MD

Original Issue Date

07/08/1981

Effective Date

07/08/1981

Expiration Date

07/31/1984

City

CENTRALIA

State

Zip

62801

County

MARION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006