BENJAMIN JAMES BRUBAKER

Business Entity
ACTIVE

Dentist

LICENSED DENTIST CONTROLLED SUBSTANCE

31*****11

ACTIVE

N

BENJAMIN

JAMES

BRUBAKER

BENJAMIN JAMES BRUBAKER

02/28/2006

08/02/2024

09/30/2027

EDWARDSVILLE

IL

62025

SAINT CLAIR

II III IV V

N

08/02/2024