BRENDAN SMITH Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****13

License Status

ACTIVE

Business

First Name

BRENDAN

Last Name

SMITH

Business Name

BRENDAN SMITH

Original Issue Date

07/24/2023

Effective Date

09/16/2024

Expiration Date

09/30/2027

City

QUINCY

State

Zip

62305

County

ADAMS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/16/2024