JEFFREY T BRUNSON Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****07

License Status

ACTIVE

Business

First Name

JEFFREY

Middle

Last Name

BRUNSON

Business Name

JEFFREY T BRUNSON

Original Issue Date

10/23/2003

Effective Date

09/10/2024

Expiration Date

09/30/2027

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/10/2024