BRIAN ANTHONY PRUDENT DMD - Dentist License in Illinois | # 137000803

BRIAN ANTHONY PRUDENT DMD

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000803

License Status

ACTIVE

Business

N

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

State

IL

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

N

LastModifiedDate

05/01/2024