BRAD E MCCOLLOM
Osteopathic Medicine at Bay St, Sebastian, FL

License number
Florida 9270
Issued Date
Jul 16, 2004
Effective Date
Sep 23, 2013
Expiration Date
Mar 31, 2018
Category
Health Care
Type
Osteopathic Physician
Address
Address
8005 Bay St SUITE 5, Sebastian, FL 32958
Phone
(772) 581-1807
LicenseFiles verified this license of Jun 1, 2017 at the Health Care Practitioner Data Portal.

Organization information

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Brad E Mccollom, DO

8005 Bay St, Sebastian, FL 32958

Industry:
Neurosurgeon
Phone:
(772) 581-8075 (Phone)

BRAD E. MCCOLLOM, D.O., PA

1327 N Central Ave, Sebastian, FL 32958

Status:
Inactive
Industry:
Osteopathic Physician's Office
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Jun 23, 2004
Inactive since:
Sep 25, 2009
State ID:
P04000095908
Business type:
Florida Profit Corporation
President, Treasurer, Director, Secretary:
Brad Ed.o. Mccollom President, Treasurer, Director, Secretary, inactive, 1327 N Central Ave, Sebastian, FL 32958 (Physical)
Agent:
Rene Vandevoorde,1327 N Central Ave, Sebastian, FL 32958 (Physical)
EIN:
N/A

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