ROBIN MONTGOMERY HATHORN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001167

License Status

NOT RENEWED

Business

First Name

ROBIN

Middle

MONTGOMERY

Last Name

HATHORN

Business Name

ROBIN MONTGOMERY HATHORN

Original Issue Date

06/15/1999

Effective Date

06/15/1999

Expiration Date

06/30/2001

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005