BRIAN G KOUKOL DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****71

License Status

NOT RENEWED

Business

First Name

BRIAN G

Last Name

KOUKOL

Suffix

DDS

Business Name

BRIAN G KOUKOL DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2002

City

CRYSTAL LAKE

State

Zip

60014

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005