ELLA JEAN WOODS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****04

License Status

NOT RENEWED

Business

First Name

ELLA

Middle

JEAN

Last Name

WOODS

Business Name

ELLA JEAN WOODS

Original Issue Date

02/28/2011

Effective Date

02/28/2011

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60643

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012