MARY E TIERNEY DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000490

License Status

NOT RENEWED

Business

First Name

MARY

Middle

Last Name

TIERNEY

Suffix

DDS

Business Name

MARY E TIERNEY DDS

Original Issue Date

12/03/1999

Effective Date

08/24/2009

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60625

County

COOK

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

LastModifiedDate

11/14/2012