KURTIS CRANDELL BRAY DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****11

License Status

NOT RENEWED

Business

First Name

KURTIS

Middle

CRANDELL

Last Name

BRAY

Suffix

DMD

Business Name

KURTIS CRANDELL BRAY DMD

Original Issue Date

09/14/2010

Effective Date

09/20/2012

Expiration Date

09/30/2015

City

LOVES PARK

State

Zip

61111

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

IV V

Ever Disciplined

LastModifiedDate

02/08/2016