BEAU BRADLEY SHAY DPM Podiatrist License verification

Business Entity

ACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****13

License Status

ACTIVE

Business

First Name

BEAU

Middle

BRADLEY

Last Name

SHAY

Suffix

DPM

Business Name

BEAU BRADLEY SHAY DPM

Original Issue Date

04/21/2011

Effective Date

01/16/2025

Expiration Date

01/31/2027

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/16/2025