BRADLEY MATTHEW WOLF Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002938

License Status

NOT RENEWED

Business

First Name

BRADLEY

Middle

MATTHEW

Last Name

WOLF

Business Name

BRADLEY MATTHEW WOLF

Original Issue Date

01/29/2007

Effective Date

01/09/2020

Expiration Date

03/01/2022

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

07/27/2022