BRIAN R DE GISE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****12

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

DE GISE

Suffix

DDS

Business Name

BRIAN R DE GISE DDS

Original Issue Date

07/27/1992

Effective Date

07/27/1992

Expiration Date

09/30/1994

City

ALGONQUIN

State

Zip

60102

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005