BRADLEY J CLODFELTER OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****11

License Status

NOT RENEWED

Business

First Name

BRADLEY

Middle

Last Name

CLODFELTER

Suffix

Business Name

BRADLEY J CLODFELTER OD

Original Issue Date

09/17/1996

Effective Date

03/03/2014

Expiration Date

03/31/2016

City

CHICAGO

State

Zip

60655

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/20/2016