MILES EDWIN BRUNDAGE DDS - Dentist License in Illinois | # 019013316

MILES EDWIN BRUNDAGE DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019013316

License Status

NOT RENEWED

Business

N

First Name

MILES EDWIN

Last Name

BRUNDAGE

Suffix

DDS

Business Name

MILES EDWIN BRUNDAGE DDS

Original Issue Date

07/16/1968

Effective Date

07/16/2015

Expiration Date

09/30/2018

State

IL

Ever Disciplined

N

LastModifiedDate

10/31/2018