TIMOTHY M CHURCH DDS 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

TIMOTHY M

Last Name

CHURCH

Suffix

DDS

Business Name

TIMOTHY M CHURCH DDS

Original Issue Date

12/14/1990

Effective Date

12/14/1990

Expiration Date

09/30/1992

City

GREAT LAKES

State

Zip

60088

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005