BRIAN A FERBER DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****17

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

FERBER

Suffix

DMD

Business Name

BRIAN A FERBER DMD

Original Issue Date

04/22/2003

Effective Date

04/22/2003

Expiration Date

09/30/2004

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005