SCOTT EDWARD BERDELLE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****42

License Status

NOT RENEWED

Business

Title

DDS

First Name

SCOTT

Middle

EDWARD

Last Name

BERDELLE

Business Name

SCOTT EDWARD BERDELLE DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1986

City

ANTIOCH

State

Zip

60002

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005