JORDAN C DESCHAMPS BRALY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

NOT RENEWED

Business

First Name

JORDAN

Middle

Last Name

DESCHAMPS BRALY

Suffix

Business Name

JORDAN C DESCHAMPS BRALY MD

Original Issue Date

06/04/2010

Effective Date

06/04/2010

Expiration Date

07/31/2011

City

OKLAHOMA CITY

State

Zip

73112

County

OKLAHOMA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011