BART E EISENBARTH DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****76

License Status

NOT RENEWED

Business

First Name

BART

Middle

Last Name

EISENBARTH

Suffix

DDS

Business Name

BART E EISENBARTH DDS

Original Issue Date

09/01/2005

Effective Date

09/01/2005

Expiration Date

09/30/2006

City

ROUND LAKE BEACH

State

Zip

60073

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006