DEBORAH ANNE BLAINE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****15

License Status

NOT RENEWED

Business

First Name

DEBORAH

Middle

ANNE

Last Name

BLAINE

Suffix

DDS

Business Name

DEBORAH ANNE BLAINE DDS

Original Issue Date

10/18/2000

Effective Date

07/10/2018

Expiration Date

01/31/2022

City

CHICAGO

State

Zip

60601

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022