THEODORE V MALMBERG DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****00

License Status

NOT RENEWED

Business

First Name

THEODORE V

Last Name

MALMBERG

Suffix

DDS

Business Name

THEODORE V MALMBERG DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1984

City

BLUE ISLAND

State

Zip

60406

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005