CHARLES L BRANDENBURG III DDS 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

CHARLES L

Last Name

BRANDENBURG III

Suffix

DDS

Business Name

CHARLES L BRANDENBURG III DDS

Original Issue Date

07/30/1990

Effective Date

07/30/1990

Expiration Date

09/30/1992

City

OAK PARK

State

Zip

60302

County

COOK

Controlled Substance Schedule

III IV

Ever Disciplined

LastModifiedDate

10/13/2005