BRIAN RUSSELL GARCIA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****65

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

RUSSELL

Last Name

GARCIA

Business Name

BRIAN RUSSELL GARCIA

Original Issue Date

12/10/2021

Effective Date

12/10/2021

Expiration Date

09/30/2024

City

DEKALB

State

Zip

60115

County

DEKALB

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025