ROBIN BRENT BLAKKOLB DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000139

License Status

NOT RENEWED

Business

First Name

ROBIN BRENT

Last Name

BLAKKOLB

Suffix

DDS

Business Name

ROBIN BRENT BLAKKOLB DDS

Original Issue Date

01/01/1998

Effective Date

08/16/2018

Expiration Date

01/31/2022

City

DOWNERS GROVE

State

Zip

60516

County

DUPAGE

Specialty/Qualifier

Deep Sedation and General Anesthesia

Ever Disciplined

LastModifiedDate

05/09/2022