LEWIS C BASKINS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****05

License Status

NOT RENEWED

Business

Title

DDS

First Name

LEWIS

Middle

Last Name

BASKINS

Business Name

LEWIS C BASKINS DDS

Original Issue Date

07/01/1991

Effective Date

03/12/2012

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60636

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012