BRADLEY A JOHNSON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034123

License Status

EXPIRED

Business

First Name

BRADLEY

Middle

Last Name

JOHNSON

Suffix

Business Name

BRADLEY A JOHNSON MD

Original Issue Date

05/04/1996

Effective Date

05/04/1996

Expiration Date

06/30/1999

City

PEORIA

State

Zip

61637

County

PEORIA

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/22/2006