BRIAN LEE KLOBERDANZ Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****20

License Status

NOT RENEWED

Business

First Name

BRIAN LEE

Last Name

KLOBERDANZ

Business Name

BRIAN LEE KLOBERDANZ

Original Issue Date

12/13/1990

Effective Date

09/18/2018

Expiration Date

01/31/2022

City

DEKALB

State

Zip

60115

County

DEKALB

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022