PETRA BOUTROS DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****23

License Status

ACTIVE

Business

Title

DMD

First Name

PETRA

Last Name

BOUTROS

Business Name

PETRA BOUTROS DMD

Original Issue Date

12/13/2024

Effective Date

12/13/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60642

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/24/2025