ROBERT ALLEN BERQUIST DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****97

License Status

NOT RENEWED

Business

First Name

ROBERT ALLEN

Last Name

BERQUIST

Suffix

DDS

Business Name

ROBERT ALLEN BERQUIST DDS

Original Issue Date

01/01/1998

Effective Date

09/01/2015

Expiration Date

09/30/2018

City

FLOSSMOOR

State

Zip

60422

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018