BRIAN ANTHONY PRUDENT DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000803

License Status

ACTIVE

Business

First Name

BRIAN

Middle

ANTHONY

Last Name

PRUDENT

Suffix

DMD

Business Name

BRIAN ANTHONY PRUDENT DMD

Original Issue Date

11/17/2010

Effective Date

05/01/2024

Expiration Date

09/30/2027

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

05/01/2024