BRADLEY RICHARD HENNENFENT MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036071211

License Status

INACTIVE

Business

First Name

BRADLEY

Middle

RICHARD

Last Name

HENNENFENT

Suffix

Business Name

BRADLEY RICHARD HENNENFENT MD

Original Issue Date

07/22/1985

Effective Date

07/22/1985

Expiration Date

07/31/1996

City

SMITHSHIRE

State

Zip

61478

County

WARREN

Ever Disciplined

LastModifiedDate

09/20/2006