BRADLEY J BUNDERLE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000531

License Status

NOT RENEWED

Business

First Name

BRADLEY J

Last Name

BUNDERLE

Business Name

BRADLEY J BUNDERLE

Original Issue Date

04/27/1993

Effective Date

04/27/1993

Expiration Date

03/01/1998

City

SULLIVAN

State

Zip

61951

County

MOULTRIE

Ever Disciplined

LastModifiedDate

09/26/2006