STEPHEN R BRADDOCK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

ACTIVE

Business

Title

First Name

STEPHEN

Middle

Last Name

BRADDOCK

Business Name

STEPHEN R BRADDOCK MD

Original Issue Date

08/25/2010

Effective Date

10/15/2024

Expiration Date

07/31/2026

City

SAINT LOUIS

State

Zip

63104

County

MISSOURI

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/15/2024