EDWARD ELAM BRUEN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000227

License Status

NOT RENEWED

Business

Title

DMD

First Name

EDWARD

Middle

ELAM

Last Name

BRUEN

Business Name

EDWARD ELAM BRUEN DMD

Original Issue Date

02/15/1990

Effective Date

10/01/2009

Expiration Date

09/30/2012

City

ELMHURST

State

Zip

60126

County

DUPAGE

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

LastModifiedDate

11/14/2012