TIMOTHY MICHAEL SHANAHAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****21

License Status

NOT RENEWED

Business

First Name

TIMOTHY MICHAEL

Last Name

SHANAHAN

Business Name

TIMOTHY MICHAEL SHANAHAN

Original Issue Date

09/26/1984

Effective Date

10/01/2018

Expiration Date

01/31/2022

City

AURORA

State

Zip

60504

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022