SHAUN ERIC SOUCIE 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

SHAUN

Middle

ERIC

Last Name

SOUCIE

Suffix

DDS

Business Name

SHAUN ERIC SOUCIE DDS

Original Issue Date

08/09/2006

Effective Date

06/04/2009

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012