BRUCE MERRILL TENNEBAUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036043713

License Status

NOT RENEWED

Business

First Name

BRUCE MERRILL

Last Name

TENNEBAUM

Suffix

Business Name

BRUCE MERRILL TENNEBAUM MD

Original Issue Date

08/10/1970

Effective Date

08/10/1970

City

MINNEAPOLIS

State

Zip

55404

County

MINNESOTA

Ever Disciplined

LastModifiedDate

09/20/2006