BERNADETTE A FA Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

RESTRICTED FACULTY LICENSE

License Number

136000138

License Status

EXPIRED

Business

First Name

BERNADETTE

Middle

Last Name

Business Name

BERNADETTE A FA

Original Issue Date

09/23/2008

Effective Date

09/23/2008

Expiration Date

09/23/2011

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

09/30/2011