BLASE P BROWN DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****08

License Status

INACTIVE

Business

First Name

BLASE P

Last Name

BROWN

Suffix

DDS

Business Name

BLASE P BROWN DDS

Original Issue Date

05/02/1984

Effective Date

06/07/2018

Expiration Date

12/31/2021

City

LYONS

State

Zip

60534

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/27/2021