BRUCE S LEPOLSTAT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

NOT RENEWED

Business

First Name

BRUCE S

Last Name

LEPOLSTAT

Suffix

Business Name

BRUCE S LEPOLSTAT MD

Original Issue Date

06/21/1983

Effective Date

06/21/1983

Expiration Date

07/31/1990

City

CHICAGO HEIGHTS

State

Zip

60411

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006