NEIL BRUCE HAGEN DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****61

License Status

INACTIVE

Business

First Name

NEIL

Middle

BRUCE

Last Name

HAGEN

Suffix

DDS

Business Name

NEIL BRUCE HAGEN DDS

Original Issue Date

12/26/2007

Effective Date

06/07/2018

Expiration Date

12/31/2021

City

CHICAGO

State

Zip

60661

County

COOK

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/06/2021