BRIAN A BAIN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****38

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

BAIN DDS

Business Name

BRIAN A BAIN DDS

Original Issue Date

06/09/2010

Effective Date

06/09/2010

Expiration Date

09/30/2012

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012