MARK S BRADEL Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****06

License Status

NOT RENEWED

Business

First Name

MARK S

Last Name

BRADEL

Business Name

MARK S BRADEL

Original Issue Date

12/29/1988

Effective Date

12/29/1988

Expiration Date

09/30/2002

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/29/2016