GAY WINIFRED BRODERSEN DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****44

License Status

ACTIVE

Business

First Name

GAY

Middle

WINIFRED

Last Name

BRODERSEN

Suffix

DDS

Business Name

GAY WINIFRED BRODERSEN DDS

Original Issue Date

08/10/1994

Effective Date

10/01/2024

Expiration Date

09/30/2027

City

SCHAUMBURG

State

Zip

60195

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/04/2024