BRANDON DANIEL FULL Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****80

License Status

ACTIVE

Business

First Name

BRANDON

Middle

DANIEL

Last Name

FULL

Business Name

BRANDON DANIEL FULL

Original Issue Date

06/22/2023

Effective Date

03/20/2025

Expiration Date

09/30/2027

City

CRYSTAL LAKE

State

Zip

60012

County

MCHENRY

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

03/20/2025