ROBIN MONTGOMERY HATHORN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****11

License Status

NOT RENEWED

Business

First Name

ROBIN

Middle

MONTGOMERY

Last Name

HATHORN

Business Name

ROBIN MONTGOMERY HATHORN

Original Issue Date

12/05/2001

Effective Date

12/05/2001

Expiration Date

09/30/2006

City

CHICAGO

State

Zip

60605

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006