SUSAN L BRACKER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****69

License Status

NOT RENEWED

Business

First Name

SUSAN L

Last Name

BRACKER

Business Name

SUSAN L BRACKER

Original Issue Date

04/16/1987

Effective Date

04/16/1987

Expiration Date

09/30/1988

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005