KEVEN TAYLOR COOK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****01

License Status

NOT RENEWED

Business

First Name

KEVEN TAYLOR

Last Name

COOK

Business Name

KEVEN TAYLOR COOK

Original Issue Date

07/28/1982

Effective Date

07/28/1982

Expiration Date

09/30/1984

City

FOREST PARK

State

Zip

60130

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005