WILLIAM HENRY BRUNDIDGE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

ACTIVE

Business

Title

First Name

WILLIAM

Middle

HENRY

Last Name

BRUNDIDGE

Business Name

WILLIAM HENRY BRUNDIDGE MD

Original Issue Date

09/14/2023

Effective Date

09/14/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61614

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/14/2023