BRYAN C BOUCHELION DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****34

License Status

ACTIVE

Business

Title

DDS

First Name

BRYAN

Middle

Last Name

BOUCHELION

Business Name

BRYAN C BOUCHELION DDS

Original Issue Date

01/31/2005

Effective Date

09/27/2024

Expiration Date

09/30/2027

City

PLAINFIELD

State

Zip

60544

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/27/2024