LA JUANA D BRAGDON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****49

License Status

NOT RENEWED

Business

First Name

LA JUANA D

Last Name

BRAGDON

Suffix

DDS

Business Name

LA JUANA D BRAGDON DDS

Original Issue Date

05/20/1992

Effective Date

05/20/1992

Expiration Date

09/30/1998

City

CHICAGO

State

Zip

60643

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005