BRADLEY WANE ROBERTS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000241

License Status

ACTIVE

Business

First Name

BRADLEY WANE

Last Name

ROBERTS

Business Name

BRADLEY WANE ROBERTS

Original Issue Date

03/14/1990

Effective Date

09/11/2024

Expiration Date

09/30/2027

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

Deep Sedation and General Anesthesia

Ever Disciplined

LastModifiedDate

09/11/2024