THEOPHILUS BURRELL GRAY DDS Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019013078

License Status

INACTIVE

Business

First Name

THEOPHILUS

Middle

BURRELL

Last Name

GRAY

Suffix

DDS

Business Name

THEOPHILUS BURRELL GRAY DDS

Original Issue Date

12/10/1966

Effective Date

10/01/2006

Expiration Date

09/30/2009

City

CHICAGO

State

Zip

60649

County

COOK

Ever Disciplined

LastModifiedDate

06/04/2009