MICHAEL BRIAN LIEBERMAN 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

MICHAEL

Middle

BRIAN

Last Name

LIEBERMAN

Business Name

MICHAEL BRIAN LIEBERMAN

Original Issue Date

07/22/2014

Effective Date

06/22/2015

Expiration Date

09/30/2018

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018