BRANDON ALBERT BUSHONG DDS - Dentist License in Illinois | # 021002700

BRANDON ALBERT BUSHONG DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021002700

License Status

NOT RENEWED

Business

N

Title

DDS

First Name

BRANDON

Middle

ALBERT

Last Name

BUSHONG

Business Name

BRANDON ALBERT BUSHONG DDS

Original Issue Date

08/27/2015

Effective Date

06/07/2018

Expiration Date

01/31/2022

State

IL

Specialty/Qualifier

PERIODONTICS

Ever Disciplined

N

LastModifiedDate

05/09/2022