BRADLEY W DYRSTAD MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052536

License Status

EXPIRED

Business

First Name

BRADLEY

Middle

Last Name

DYRSTAD

Suffix

Business Name

BRADLEY W DYRSTAD MD

Original Issue Date

06/25/2010

Effective Date

06/25/2010

Expiration Date

06/24/2012

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

08/29/2012