LAWRENCE ALAN BLACKSTONE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****17

License Status

NOT RENEWED

Business

First Name

LAWRENCE ALAN

Last Name

BLACKSTONE

Suffix

DDS

Business Name

LAWRENCE ALAN BLACKSTONE DDS

Original Issue Date

01/01/1998

Effective Date

10/15/2012

Expiration Date

09/30/2015

City

PALATINE

State

Zip

60074

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016