BRIAN D SHIN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****60

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

Last Name

SHIN

Suffix

DDS

Business Name

BRIAN D SHIN DDS

Original Issue Date

05/10/2006

Effective Date

11/17/2010

Expiration Date

09/30/2012

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012