BRENDA R FABISCH Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****10

License Status

ACTIVE

Business

First Name

BRENDA R

Last Name

FABISCH

Business Name

BRENDA R FABISCH

Original Issue Date

10/14/1987

Effective Date

08/11/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60626

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

08/11/2024