MATTHEW WALTER BRADLEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

NOT RENEWED

Business

Title

First Name

MATTHEW

Middle

WALTER

Last Name

BRADLEY

Business Name

MATTHEW WALTER BRADLEY MD

Original Issue Date

06/07/2017

Effective Date

06/07/2017

Expiration Date

09/30/2020

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

01/14/2021