PETER J POLVERINI Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****09

License Status

NOT RENEWED

Business

First Name

PETER J

Last Name

POLVERINI

Business Name

PETER J POLVERINI

Original Issue Date

09/05/1991

Effective Date

09/05/1991

Expiration Date

09/30/1992

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005