DOROTHY D BRADLEY Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000006

License Status

NOT RENEWED

Business

First Name

DOROTHY D

Last Name

BRADLEY

Business Name

DOROTHY D BRADLEY

Original Issue Date

11/05/1980

Effective Date

11/05/1980

Expiration Date

11/05/1982

City

SPRINGFIELD

State

Zip

62703

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/26/2006