BRETT WAYNE BARLOW DMD Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001611

License Status

CANCELLED

Business

Title

DMD

First Name

BRETT

Middle

WAYNE

Last Name

BARLOW

Business Name

BRETT WAYNE BARLOW DMD

Original Issue Date

09/06/2006

Effective Date

09/06/2006

Expiration Date

06/30/2010

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

LastModifiedDate

06/22/2007