EDMUND BRUNING Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****36

License Status

ACTIVE

Business

First Name

EDMUND

Last Name

BRUNING

Business Name

EDMUND BRUNING

Original Issue Date

09/12/2024

Effective Date

12/19/2025

Expiration Date

03/01/2028

City

MARYVILLE

State

Zip

62062

County

MADISON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/19/2025