MATTHEW WALTER BRADLEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

Title

First Name

MATTHEW

Middle

WALTER

Last Name

BRADLEY

Business Name

MATTHEW WALTER BRADLEY MD

Original Issue Date

03/03/2011

Effective Date

06/22/2017

Expiration Date

09/30/2020

City

ST LOUIS

State

Zip

63122

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021