LACEY LEA KRUSE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

ACTIVE

Business

Title

First Name

LACEY

Middle

LEA

Last Name

KRUSE

Business Name

LACEY LEA KRUSE MD

Original Issue Date

06/09/2014

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

04/06/2023