BRADFORD GREENE Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000684

License Status

NOT RENEWED

Business

First Name

BRADFORD

Last Name

GREENE

Business Name

BRADFORD GREENE

Original Issue Date

06/12/1995

Effective Date

06/12/1995

Expiration Date

03/01/1998

City

GRAND RAPIDS

State

Zip

49546

County

MICHIGAN

Ever Disciplined

LastModifiedDate

09/26/2006