MILAM ALLISON BRANTLEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

NOT RENEWED

Business

First Name

MILAM

Middle

ALLISON

Last Name

BRANTLEY

Suffix

Business Name

MILAM ALLISON BRANTLEY MD

Original Issue Date

08/07/2003

Effective Date

06/24/2008

Expiration Date

07/31/2011

City

MOUNT VERNON

State

Zip

62864

County

JEFFERSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011