BRANDON ALBERT BUSHONG DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****66

License Status

NOT RENEWED

Business

Title

DDS

First Name

BRANDON

Middle

ALBERT

Last Name

BUSHONG

Business Name

BRANDON ALBERT BUSHONG DDS

Original Issue Date

06/30/2015

Effective Date

06/07/2018

Expiration Date

01/31/2022

City

SWANSEA

State

Zip

62226

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022