JACK O BRADT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

NOT RENEWED

Business

First Name

JACK O

Last Name

BRADT

Suffix

Business Name

JACK O BRADT MD

Original Issue Date

08/06/1987

Effective Date

08/06/1987

Expiration Date

07/31/1990

City

MONROE

State

Zip

53566

County

WISCONSIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006