MERWIN BERYL ROSEN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021000438

License Status

NOT RENEWED

Business

First Name

MERWIN BERYL

Last Name

ROSEN

Suffix

DDS

Business Name

MERWIN BERYL ROSEN DDS

Original Issue Date

11/25/1964

Effective Date

11/25/1964

Expiration Date

09/30/2004

City

WAUKEGAN

State

Zip

60085

County

LAKE

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

LastModifiedDate

10/17/2005

Case Number

1991007047

Action

Suspension

Discipline Start Date

05/07/1992

Discipline End Date

05/20/1992

Discipline Reason

Utilized anesthesia technique without permit.