BRADLEY KEITH HARGRAVE DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****90

License Status

ACTIVE

Business

First Name

BRADLEY

Middle

KEITH

Last Name

HARGRAVE

Suffix

DMD

Business Name

BRADLEY KEITH HARGRAVE DMD

Original Issue Date

07/06/2005

Effective Date

05/01/2024

Expiration Date

09/30/2027

City

JERSEYVILLE

State

Zip

62052

County

JERSEY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/01/2024