LARISSA MARIE CHISM BUGGS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

ACTIVE

Business

Title

First Name

LARISSA

Middle

MARIE

Last Name

CHISM BUGGS

Business Name

LARISSA MARIE CHISM BUGGS MD

Original Issue Date

04/07/2023

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

SOUTH BEND

State

Zip

46628

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023