BRYAN C BOUCHELION DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****48

License Status

NOT RENEWED

Business

Title

DDS

First Name

BRYAN

Middle

Last Name

BOUCHELION

Business Name

BRYAN C BOUCHELION DDS

Original Issue Date

02/07/2005

Effective Date

02/07/2005

Expiration Date

09/30/2006

City

JOLIET

State

Zip

60435

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006