JOHN S LILLEBERG DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****21

License Status

CANCELLED

Business

First Name

JOHN S

Last Name

LILLEBERG

Suffix

DDS

Business Name

JOHN S LILLEBERG DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2004

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

IV V

Ever Disciplined

LastModifiedDate

10/13/2005