BOGDAN ROBERT BUSAN DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001706

License Status

CANCELLED

Business

Title

DDS

First Name

BOGDAN

Middle

ROBERT

Last Name

BUSAN

Business Name

BOGDAN ROBERT BUSAN DDS

Original Issue Date

08/22/2008

Effective Date

07/01/2008

Expiration Date

06/30/2011

City

BELVIDERE

State

Zip

61008

County

BOONE

Specialty/Qualifier

Periodontics

Ever Disciplined

LastModifiedDate

08/22/2008