TIMOTHY JOSEPH BROUDER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****41

License Status

NOT RENEWED

Business

First Name

TIMOTHY JOSEPH

Last Name

BROUDER

Business Name

TIMOTHY JOSEPH BROUDER

Original Issue Date

09/01/1983

Effective Date

11/10/2021

Expiration Date

09/30/2024

City

MT PROSPECT

State

Zip

60056

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025