CHARLES A MCBROOM DMD 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

CHARLES

Middle

Last Name

MCBROOM

Suffix

DMD

Business Name

CHARLES A MCBROOM DMD

Original Issue Date

10/06/2004

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

DOLTON

State

Zip

60419

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009