RICHARD WILLIAM BRODERICK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****67

License Status

ACTIVE

Business

First Name

RICHARD

Middle

WILLIAM

Last Name

BRODERICK

Suffix

Business Name

RICHARD WILLIAM BRODERICK MD

Original Issue Date

05/14/1999

Effective Date

06/21/2023

Expiration Date

07/31/2026

City

ELGIN

State

Zip

60123

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/21/2023