JENNIFER K BRUBAKER DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****15

License Status

ACTIVE

Business

Title

DMD

First Name

JENNIFER

Middle

Last Name

BRUBAKER

Business Name

JENNIFER K BRUBAKER DMD

Original Issue Date

06/29/2006

Effective Date

08/01/2024

Expiration Date

09/30/2027

City

GLEN CARBON

State

Zip

62034

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/01/2024