DALE D SHAHAN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****12

License Status

NOT RENEWED

Business

First Name

DALE

Middle

Last Name

SHAHAN

Suffix

DDS

Business Name

DALE D SHAHAN DDS

Original Issue Date

04/09/2003

Effective Date

04/09/2003

Expiration Date

09/30/2006

City

CHICAGO

State

Zip

60632

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006