BRIAN LEE KLOBERDANZ - Dentist License in Illinois | # 137000284

BRIAN LEE KLOBERDANZ

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000284

License Status

NOT RENEWED

Business

N

First Name

BRIAN LEE

Last Name

KLOBERDANZ

Business Name

BRIAN LEE KLOBERDANZ

Original Issue Date

12/08/1990

Effective Date

10/01/2018

Expiration Date

01/31/2022

State

IL

Specialty/Qualifier

Deep Sedation and General Anesthesia

Ever Disciplined

N

LastModifiedDate

05/09/2022