EDWARD BOONE BRACKETT III MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

NOT RENEWED

Business

First Name

EDWARD BOONE

Last Name

BRACKETT III

Suffix

Business Name

EDWARD BOONE BRACKETT III MD

Original Issue Date

01/01/1997

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021