ROSALIE A WALO 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

ROSALIE A

Last Name

WALO

Business Name

ROSALIE A WALO

Original Issue Date

10/10/1983

Effective Date

10/10/1983

Expiration Date

09/30/1992

City

CHICAGO

State

Zip

60622

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005