BRUCE K CARLSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****89

License Status

NOT RENEWED

Business

Title

DDS

First Name

BRUCE

Middle

Last Name

CARLSON

Business Name

BRUCE K CARLSON DDS

Original Issue Date

12/14/1990

Effective Date

08/16/2018

Expiration Date

01/31/2022

City

NILES

State

Zip

60714

County

COOK

Controlled Substance Schedule

III IV

Ever Disciplined

LastModifiedDate

05/09/2022