BRIAN MICHAEL PENNIALL DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****03

License Status

ACTIVE

Business

First Name

BRIAN

Middle

MICHAEL

Last Name

PENNIALL

Suffix

DDS

Business Name

BRIAN MICHAEL PENNIALL DDS

Original Issue Date

08/08/2003

Effective Date

09/21/2024

Expiration Date

09/30/2027

City

ST CHARLES

State

Zip

60175

County

KANE

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

09/21/2024