BROCK W GARDNER DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****26

License Status

NOT RENEWED

Business

Title

DMD

First Name

BROCK

Middle

Last Name

GARDNER

Business Name

BROCK W GARDNER DMD

Original Issue Date

08/06/2018

Effective Date

12/09/2021

Expiration Date

09/30/2024

City

NAPERVILLE

State

Zip

60563

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025