EDWARD ELAM BRUEN DMD - Dentist License in Illinois | # 021001063

EDWARD ELAM BRUEN DMD

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021001063

License Status

INACTIVE

Business

N

Title

DMD

First Name

EDWARD

Middle

ELAM

Last Name

BRUEN

Business Name

EDWARD ELAM BRUEN DMD

Original Issue Date

06/12/1980

Effective Date

10/01/2009

Expiration Date

09/30/2012

State

IL

Specialty/Qualifier

Periodontics

Ever Disciplined

N

LastModifiedDate

06/06/2012