THEODORE F MAYER 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

THEODORE F

Last Name

MAYER

Business Name

THEODORE F MAYER

Original Issue Date

05/20/2009

Effective Date

06/26/2012

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016