MARY MELODY DAWSON WHITAKER 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

MARY

Middle

MELODY DAWSON

Last Name

WHITAKER

Business Name

MARY MELODY DAWSON WHITAKER

Original Issue Date

12/03/2015

Effective Date

12/03/2015

Expiration Date

09/30/2018

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018