JEFFREY D BRADLEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

NOT RENEWED

Business

Title

First Name

JEFFREY

Middle

Last Name

BRADLEY

Business Name

JEFFREY D BRADLEY MD

Original Issue Date

06/13/1997

Effective Date

06/28/2017

Expiration Date

09/30/2020

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021