CHARLES J GREENEBAUM Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****14

License Status

NOT RENEWED

Business

First Name

CHARLES J

Last Name

GREENEBAUM

Business Name

CHARLES J GREENEBAUM

Original Issue Date

04/15/1991

Effective Date

04/15/1991

Expiration Date

09/30/1992

City

CHICAGO

State

Zip

60602

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005