FRED EUGENE BURKHARDT DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****91

License Status

NOT RENEWED

Business

First Name

FRED

Middle

EUGENE

Last Name

BURKHARDT

Suffix

DDS

Business Name

FRED EUGENE BURKHARDT DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2002

City

CHICAGO

State

Zip

60634

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005