MARILYN PATRICE PALM DDS 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

MARILYN PATRICE

Last Name

PALM

Suffix

DDS

Business Name

MARILYN PATRICE PALM DDS

Original Issue Date

11/04/1981

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

CHICAGO

State

Zip

60615

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009