BRIAN WARD ALQUIST DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****85

License Status

NOT RENEWED

Business

First Name

BRIAN WARD

Last Name

ALQUIST

Suffix

DDS

Business Name

BRIAN WARD ALQUIST DDS

Original Issue Date

01/01/1998

Expiration Date

01/01/1998

City

WAUKEGAN

State

Zip

60085

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005