SUSAN F BURGESS DMD Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****09

License Status

INACTIVE

Business

First Name

SUSAN

Middle

Last Name

BURGESS

Suffix

DMD

Business Name

SUSAN F BURGESS DMD

Original Issue Date

09/09/1986

Effective Date

06/15/2018

Expiration Date

12/31/2021

City

ELMHURST

State

Zip

60126

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/23/2021