KRISTA MICHELLE BRUCKER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****87

License Status

NOT RENEWED

Business

Title

First Name

KRISTA

Middle

MICHELLE

Last Name

BRUCKER

Business Name

KRISTA MICHELLE BRUCKER MD

Original Issue Date

11/29/2012

Effective Date

11/29/2012

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014