PETER Q SHELLEY DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019026537

License Status

NOT RENEWED

Business

First Name

PETER

Middle

Last Name

SHELLEY

Suffix

DDS

Business Name

PETER Q SHELLEY DDS

Original Issue Date

08/05/2004

Effective Date

09/30/2004

Expiration Date

09/30/2006

City

CHICAGO

State

Zip

60607

County

COOK

Ever Disciplined

LastModifiedDate

02/08/2007