MARILYN EUGENIA BRADDOCK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****60

License Status

NOT RENEWED

Business

First Name

MARILYN EUGENIA

Last Name

BRADDOCK

Business Name

MARILYN EUGENIA BRADDOCK

Original Issue Date

09/21/1982

Effective Date

09/21/1982

Expiration Date

09/30/1986

City

WASHINGTON

State

Zip

20018

County

DISTRICT OF COLUMBIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005