KENNETH MICHAEL BRANTLEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036139039

License Status

NOT RENEWED

Business

Title

First Name

KENNETH

Middle

MICHAEL

Last Name

BRANTLEY

Business Name

KENNETH MICHAEL BRANTLEY MD

Original Issue Date

08/31/2015

Effective Date

08/31/2015

Expiration Date

07/31/2017

City

SAINT LOUIS

State

Zip

63141

County

MISSOURI

Ever Disciplined

LastModifiedDate

11/01/2017