BRIAN C CROSS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****47

License Status

NOT RENEWED

Business

First Name

BRIAN C

Last Name

CROSS

Business Name

BRIAN C CROSS

Original Issue Date

09/18/1986

Effective Date

09/28/2012

Expiration Date

09/30/2015

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016