SHALISE M HOLT DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****14

License Status

NOT RENEWED

Business

Title

DDS

First Name

SHALISE

Middle

Last Name

HOLT

Business Name

SHALISE M HOLT DDS

Original Issue Date

08/03/2015

Effective Date

08/03/2015

Expiration Date

09/30/2018

City

HANOVER PARK

State

Zip

60133

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018