ELIZABETH HELEN BRACK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****31

License Status

NOT RENEWED

Business

First Name

ELIZABETH

Middle

HELEN

Last Name

BRACK

Business Name

ELIZABETH HELEN BRACK

Original Issue Date

06/23/2011

Effective Date

09/03/2015

Expiration Date

09/30/2018

City

SAINT LOUIS

State

Zip

63139

County

MISSOURI

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018