SAMUEL JAY BERNGARD DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****58

License Status

NOT RENEWED

Business

First Name

SAMUEL JAY

Last Name

BERNGARD

Suffix

DDS

Business Name

SAMUEL JAY BERNGARD DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1988

City

HOFFMAN ESTATES

State

Zip

60195

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005