WAYNE E BRUGGEMAN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****21

License Status

NOT RENEWED

Business

First Name

WAYNE E

Last Name

BRUGGEMAN

Suffix

DDS

Business Name

WAYNE E BRUGGEMAN DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1994

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005