BRIAN RUSSELL GARCIA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****24

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

RUSSELL

Last Name

GARCIA

Business Name

BRIAN RUSSELL GARCIA

Original Issue Date

09/04/2018

Effective Date

09/04/2018

Expiration Date

01/31/2022

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022