DAVID SAM BARTOLONE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****16

License Status

NOT RENEWED

Business

First Name

DAVID SAM

Last Name

BARTOLONE

Business Name

DAVID SAM BARTOLONE

Original Issue Date

03/18/1985

Effective Date

03/18/1985

Expiration Date

09/30/1996

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005