AVERY C POWELL DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000427

License Status

NOT RENEWED

Business

First Name

AVERY

Middle

Last Name

POWELL

Suffix

DDS

Business Name

AVERY C POWELL DDS

Original Issue Date

05/03/1997

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

MATTESON

State

Zip

60443

County

COOK

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

LastModifiedDate

11/04/2009