BRADLEY W STORM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125018911

License Status

EXPIRED

Business

First Name

BRADLEY W

Last Name

STORM

Suffix

Business Name

BRADLEY W STORM MD

Original Issue Date

07/26/1985

Effective Date

07/26/1985

Expiration Date

09/01/1988

City

SPRINGFIELD

State

Zip

62708

County

SANGAMON

Specialty/Qualifier

Addiction Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006