License holder summary

BRADLEY WADE JELLIS is a Board Of Medicine licensed to practice in Idaho. The address on file for BRADLEY WADE JELLIS is 12610 RIATA TRACE PKWY APT. 731 AUSTIN TX 78727. This licensed professional license is not current. The license was granted 10/29/2007 and expired on 08/01/2009.

Idaho

Division of Occupational and Professional Licenses

BRADLEY WADE JELLIS
Board Of Medicine
License number
AT-318
Date granted
10/29/2007
Date expires
08/01/2009
Class
Board Of Medicine
Status
Canceled
Address
12610 RIATA TRACE PKWY APT. 731 AUSTIN TX 78727
idaholicensing.com
ID 48355540
LAST UPDATED 2024-04-22 07:27:35 UTC

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