DONALD JAY BERQUIST DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****88

License Status

ACTIVE

Business

Title

DMD

First Name

DONALD

Middle

JAY

Last Name

BERQUIST

Business Name

DONALD JAY BERQUIST DMD

Original Issue Date

06/17/2020

Effective Date

09/18/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/18/2024