BRADLEY WANE ROBERTS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****71

License Status

ACTIVE

Business

First Name

BRADLEY WANE

Last Name

ROBERTS

Business Name

BRADLEY WANE ROBERTS

Original Issue Date

05/20/1996

Effective Date

08/29/2024

Expiration Date

09/30/2027

City

GRANITE CITY

State

Zip

62040

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/29/2024