BRADLEY L JOHNSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

NOT RENEWED

Business

First Name

BRADLEY L

Last Name

JOHNSON

Suffix

Business Name

BRADLEY L JOHNSON MD

Original Issue Date

01/09/2007

Effective Date

01/09/2007

Expiration Date

07/31/2008

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020