BRIAN RAYMOND ETSCHEID Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****74

License Status

NOT RENEWED

Business

First Name

BRIAN RAYMOND

Last Name

ETSCHEID

Business Name

BRIAN RAYMOND ETSCHEID

Original Issue Date

12/02/1985

Effective Date

12/02/1985

Expiration Date

09/30/1986

City

CHICAGO HEIGHTS

State

Zip

60411

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005