MICHAEL D PALMER Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****09

License Status

CANCELLED

Business

First Name

MICHAEL D

Last Name

PALMER

Business Name

MICHAEL D PALMER

Original Issue Date

03/26/1990

Effective Date

03/26/1990

Expiration Date

09/30/1992

City

MANTENDO

State

Zip

60950

County

KANKAKEE

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/13/2005