BRADLY R BUSH DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****80

License Status

ACTIVE

Business

First Name

BRADLY R

Last Name

BUSH

Suffix

DMD

Business Name

BRADLY R BUSH DMD

Original Issue Date

05/16/1990

Effective Date

09/22/2024

Expiration Date

09/30/2027

City

MARYVILLE

State

Zip

62062

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/22/2024