MICHELLE RAE BRADDY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

NOT RENEWED

Business

Title

First Name

MICHELLE

Middle

RAE

Last Name

BRADDY

Business Name

MICHELLE RAE BRADDY MD

Original Issue Date

06/20/2008

Effective Date

06/22/2011

Expiration Date

07/31/2014

City

DIETERICH

State

Zip

62424

County

EFFINGHAM

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020