EDWARD ELAM BRUEN DMD - Dentist License in Illinois | # 137000227

EDWARD ELAM BRUEN DMD

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000227

License Status

NOT RENEWED

Business

N

Title

DMD

First Name

EDWARD

Middle

ELAM

Last Name

BRUEN

Business Name

EDWARD ELAM BRUEN DMD

Original Issue Date

02/15/1990

Effective Date

10/01/2009

Expiration Date

09/30/2012

State

IL

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

N

LastModifiedDate

11/14/2012