AUSTIN POTRUE DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****02

License Status

ACTIVE

Business

Title

DMD

First Name

AUSTIN

Last Name

POTRUE

Business Name

AUSTIN POTRUE DMD

Original Issue Date

06/24/2022

Effective Date

05/09/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60647

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2024