JACOB ALEXANDER BRADDOCK DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

ACTIVE

Business

Title

First Name

JACOB

Middle

ALEXANDER

Last Name

BRADDOCK

Business Name

JACOB ALEXANDER BRADDOCK DO

Original Issue Date

06/30/2025

Effective Date

06/30/2025

Expiration Date

07/31/2026

City

ROBINSON

State

Zip

62454

County

CRAWFORD

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/30/2025