THEODORE GARY LOIBEN Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****21

License Status

CANCELLED

Business

First Name

THEODORE GARY

Last Name

LOIBEN

Business Name

THEODORE GARY LOIBEN

Original Issue Date

04/28/1992

Effective Date

04/28/1992

Expiration Date

09/30/1992

City

CHICAGO

State

Zip

60608

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005