JOHN ALVIN BAZLEY - Medical Doctor License in Wisconsin | # 33*****53

JOHN ALVIN BAZLEY

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

ACTIVE

Business

N

First Name

JOHN

Middle

ALVIN

Last Name

BAZLEY

Business Name

JOHN ALVIN BAZLEY

Original Issue Date

01/29/2014

Effective Date

08/01/2023

Expiration Date

07/31/2026

State

WI

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

08/01/2023