BRENT ALLEN RUDISEL DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036111757

License Status

ACTIVE

Business

First Name

BRENT

Middle

ALLEN

Last Name

RUDISEL

Suffix

Business Name

BRENT ALLEN RUDISEL DO

Original Issue Date

07/02/2004

Effective Date

07/19/2023

Expiration Date

07/31/2026

City

FAIRFIELD

State

Zip

62837

County

WAYNE

Ever Disciplined

LastModifiedDate

07/19/2023