CARINA B CHAVEZ Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****10

License Status

NOT RENEWED

Business

First Name

CARINA

Middle

Last Name

CHAVEZ

Business Name

CARINA B CHAVEZ

Original Issue Date

04/25/2002

Effective Date

04/25/2002

Expiration Date

09/30/2004

City

CHICAGO

State

Zip

60641

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005