License holder summary

Perry Albert Brucker is a Controlled Substance Registration - Physician licensed to practice in Indiana. The address on file for Perry Albert Brucker is 9726 A Coldwater Road, Fort Wayne IN 46825. This licensed professional license is current. The license was granted 04/30/1986 and expired on 10/31/2015.

Indiana

Professional Licensing Agency

Perry Albert Brucker
Controlled Substance Registration - Physician
License number
01018660B
Date granted
04/30/1986
Date expires
10/31/2015
Class
Controlled Substance Registration - Physician
Status
Active
Address
9726 A Coldwater Road, Fort Wayne IN 46825
indianalicensing.org
ID 5854180
LAST UPDATED 2024-01-30 12:13:55 UTC

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