MARIA A EJSBRENNER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****36

License Status

NOT RENEWED

Business

First Name

MARIA A

Last Name

EJSBRENNER

Business Name

MARIA A EJSBRENNER

Original Issue Date

10/30/1989

Effective Date

10/30/1989

Expiration Date

09/30/1996

City

CHICAGO

State

Zip

60646

County

COOK

Controlled Substance Schedule

III

Ever Disciplined

LastModifiedDate

10/13/2005