DAVID J BRANDIS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****72

License Status

NOT RENEWED

Business

First Name

DAVID J

Last Name

BRANDIS

Suffix

DDS

Business Name

DAVID J BRANDIS DDS

Original Issue Date

01/01/1998

Effective Date

08/25/2009

Expiration Date

09/30/2012

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012