BRADY NOLAN BENHAM 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

BRADY

Middle

NOLAN

Last Name

BENHAM

Suffix

Business Name

BRADY NOLAN BENHAM MD

Original Issue Date

06/15/2000

Effective Date

06/15/2000

Expiration Date

07/31/2008

City

SCOTT AFB

State

Zip

62225

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008