BRADLEY IVAN Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****37

License Status

ACTIVE

Business

First Name

BRADLEY

Last Name

IVAN

Business Name

BRADLEY IVAN

Original Issue Date

01/16/2019

Effective Date

12/05/2025

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60611

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/05/2025