BRENT TOLLERUD DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****72

License Status

NOT RENEWED

Business

Title

DMD

First Name

BRENT

Last Name

TOLLERUD

Business Name

BRENT TOLLERUD DMD

Original Issue Date

07/09/2018

Effective Date

07/09/2018

Expiration Date

01/31/2022

City

VICTORIA

State

Zip

55386

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022