CARLTON BRUCE HAGSTROM DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****05

License Status

NOT RENEWED

Business

First Name

CARLTON BRUCE

Last Name

HAGSTROM

Suffix

DDS

Business Name

CARLTON BRUCE HAGSTROM DDS

Original Issue Date

01/01/1998

Effective Date

06/07/2018

Expiration Date

01/31/2022

City

FOX LAKE

State

Zip

60020

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022