JERALD J BRATBERG MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

NOT RENEWED

Business

First Name

JERALD J

Last Name

BRATBERG

Suffix

Business Name

JERALD J BRATBERG MD

Original Issue Date

01/01/1997

Effective Date

07/13/2011

Expiration Date

07/31/2014

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014