SUSAN A STACKER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000838

License Status

NOT RENEWED

Business

First Name

SUSAN A

Last Name

STACKER

Suffix

DDS

Business Name

SUSAN A STACKER DDS

Original Issue Date

06/01/1995

Effective Date

06/01/1995

Expiration Date

05/30/1998

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Periodontics

Ever Disciplined

LastModifiedDate

10/12/2005