BRUCE LEE WHITAKER DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

ACTIVE

Business

Title

First Name

BRUCE

Middle

LEE

Last Name

WHITAKER

Business Name

BRUCE LEE WHITAKER DO

Original Issue Date

04/12/2022

Effective Date

05/20/2023

Expiration Date

07/31/2026

City

MACOMB

State

Zip

48042

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/20/2023