CLINT E BRADFORD DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****72

License Status

NOT RENEWED

Business

First Name

CLINT

Middle

Last Name

BRADFORD

Suffix

DMD

Business Name

CLINT E BRADFORD DMD

Original Issue Date

06/26/2000

Effective Date

06/26/2000

Expiration Date

09/30/2002

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005