BRAD L SUPRENANT DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036071427

License Status

ACTIVE

Business

First Name

BRAD L

Last Name

SUPRENANT

Suffix

Business Name

BRAD L SUPRENANT DO

Original Issue Date

08/13/1985

Effective Date

05/13/2023

Expiration Date

07/31/2026

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Ever Disciplined

LastModifiedDate

05/13/2023