STEPHANIE M BURRELL DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001134

License Status

NOT RENEWED

Business

First Name

STEPHANIE

Middle

Last Name

BURRELL

Suffix

DDS

Business Name

STEPHANIE M BURRELL DDS

Original Issue Date

09/24/1998

Effective Date

09/24/1998

Expiration Date

06/30/1999

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005