BRIAN TODD EVANS SR DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000846

License Status

NOT RENEWED

Business

First Name

BRIAN TODD

Last Name

EVANS SR

Suffix

DDS

Business Name

BRIAN TODD EVANS SR DDS

Original Issue Date

08/01/2012

Effective Date

08/01/2012

Expiration Date

09/30/2015

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

02/08/2016