CHESKA AVERY-STAFFORD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****30

License Status

NOT RENEWED

Business

First Name

CHESKA

Last Name

AVERY-STAFFORD

Business Name

CHESKA AVERY-STAFFORD

Original Issue Date

11/14/2006

Effective Date

11/14/2006

Expiration Date

09/30/2009

City

NORRIDGE

State

Zip

60706

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009