BRADLEY A WILSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****27

License Status

ACTIVE

Business

First Name

BRADLEY

Middle

Last Name

WILSON

Suffix

Business Name

BRADLEY A WILSON MD

Original Issue Date

06/01/2007

Effective Date

04/26/2023

Expiration Date

07/31/2026

City

MATTOON

State

Zip

61938

County

COLES

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/26/2023