MAXIME GREGORY BOUVAGNET DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****46

License Status

NOT RENEWED

Business

Title

DMD

First Name

MAXIME

Middle

GREGORY

Last Name

BOUVAGNET

Business Name

MAXIME GREGORY BOUVAGNET DMD

Original Issue Date

10/30/2023

Effective Date

10/30/2023

Expiration Date

09/30/2024

City

BROOKFIELD

State

Zip

60513

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025