BRANDON ALBERT BUSHONG DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021002700

License Status

NOT RENEWED

Business

Title

DDS

First Name

BRANDON

Middle

ALBERT

Last Name

BUSHONG

Business Name

BRANDON ALBERT BUSHONG DDS

Original Issue Date

08/27/2015

Effective Date

06/07/2018

Expiration Date

01/31/2022

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Specialty/Qualifier

PERIODONTICS

Ever Disciplined

LastModifiedDate

05/09/2022