KENNETH ROBERT BROCKER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****52

License Status

NOT RENEWED

Business

First Name

KENNETH ROBERT

Last Name

BROCKER

Suffix

DDS

Business Name

KENNETH ROBERT BROCKER DDS

Original Issue Date

01/01/1998

Effective Date

09/24/2018

Expiration Date

01/31/2022

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022