LISA NOELLE RUCKMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

NOT RENEWED

Business

Title

First Name

LISA

Middle

NOELLE

Last Name

RUCKMAN

Business Name

LISA NOELLE RUCKMAN MD

Original Issue Date

09/13/2012

Effective Date

09/13/2012

Expiration Date

07/31/2014

City

PEORIA

State

Zip

61602

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014