RANDALL R PENN DDS 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

RANDALL R

Last Name

PENN

Suffix

DDS

Business Name

RANDALL R PENN DDS

Original Issue Date

01/01/1998

Expiration Date

06/01/1982

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005