SHANNON CHANEL WILSON BRADLEY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****98

License Status

ACTIVE

Business

Title

First Name

SHANNON

Middle

CHANEL

Last Name

WILSON BRADLEY

Business Name

SHANNON CHANEL WILSON BRADLEY MD

Original Issue Date

05/26/2020

Effective Date

04/05/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60643

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/16/2023