GEORGE WILLIAM BRENT DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****58

License Status

CANCELLED

Business

First Name

GEORGE

Middle

WILLIAM

Last Name

BRENT

Suffix

DDS

Business Name

GEORGE WILLIAM BRENT DDS

Original Issue Date

10/07/1988

Effective Date

10/07/1988

Expiration Date

09/30/1992

City

SKOKIE

State

Zip

60077

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005