BRIAN C BACK DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019027792

License Status

ACTIVE

Business

First Name

BRIAN

Middle

Last Name

BACK

Suffix

DMD

Business Name

BRIAN C BACK DMD

Original Issue Date

08/05/2008

Effective Date

06/17/2024

Expiration Date

09/30/2027

City

SHILOH

State

Zip

62221

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

06/17/2024