KIM ELVIN LARSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****25

License Status

NOT RENEWED

Business

First Name

KIM ELVIN

Last Name

LARSON

Business Name

KIM ELVIN LARSON

Original Issue Date

04/11/1984

Effective Date

04/11/1984

Expiration Date

09/30/1986

City

CHICAGO

State

Zip

60652

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005