CHANTISTE BEAL DMD Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001589

License Status

CANCELLED

Business

Title

DMD

First Name

CHANTISTE

Last Name

BEAL

Business Name

CHANTISTE BEAL DMD

Original Issue Date

06/22/2006

Effective Date

06/22/2006

Expiration Date

06/30/2010

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

LastModifiedDate

06/22/2006