ILENE JETTA GREENBLATT DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****02

License Status

NOT RENEWED

Business

First Name

ILENE JETTA

Last Name

GREENBLATT

Suffix

DDS

Business Name

ILENE JETTA GREENBLATT DDS

Original Issue Date

11/02/1981

Effective Date

11/02/1981

Expiration Date

09/30/2006

City

CHICAGO

State

Zip

60613

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006