MARK S BRADEL Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****62

License Status

ACTIVE

Business

First Name

MARK S

Last Name

BRADEL

Business Name

MARK S BRADEL

Original Issue Date

09/05/2006

Effective Date

08/14/2024

Expiration Date

09/30/2027

City

ROSCOE

State

Zip

61073

County

WINNEBAGO

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/14/2024