BRIAN JOHN LOFSTROM DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****01

License Status

NOT RENEWED

Business

First Name

BRIAN JOHN

Last Name

LOFSTROM

Suffix

DDS

Business Name

BRIAN JOHN LOFSTROM DDS

Original Issue Date

08/31/1998

Effective Date

08/31/1998

Expiration Date

09/30/2000

City

CHICAGO

State

Zip

60640

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005