BRIAN T FITZGIBBONS 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 T

Last Name

FITZGIBBONS

Business Name

BRIAN T FITZGIBBONS

Original Issue Date

10/25/1982

Effective Date

09/30/2021

Expiration Date

09/30/2024

City

PALOS PARK

State

Zip

60464

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025