BRYAN STEPHEN BERTEAUX JR DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000705

License Status

NOT RENEWED

Business

First Name

BRYAN

Middle

STEPHEN

Last Name

BERTEAUX

Suffix

JR DMD

Business Name

BRYAN STEPHEN BERTEAUX JR DMD

Original Issue Date

06/25/1993

Effective Date

06/25/1993

Expiration Date

06/30/1994

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005