BRADLEY LAINE MANNING III MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

Title

First Name

BRADLEY

Middle

LAINE

Last Name

MANNING

Suffix

III

Business Name

BRADLEY LAINE MANNING III MD

Original Issue Date

11/13/2007

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011