BRADLEY D LEATHERWOOD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000630

License Status

EXPIRED

Business

First Name

BRADLEY

Middle

Last Name

LEATHERWOOD

Business Name

BRADLEY D LEATHERWOOD

Original Issue Date

03/07/2005

Effective Date

03/07/2005

Expiration Date

04/06/2005

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/25/2006