ALLEN JACK MOSES DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****29

License Status

NOT RENEWED

Business

First Name

ALLEN JACK

Last Name

MOSES

Suffix

DDS

Business Name

ALLEN JACK MOSES DDS

Original Issue Date

01/01/1998

Effective Date

06/16/2015

Expiration Date

09/30/2018

City

CHICAGO

State

Zip

60606

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018