CHESKA AVERY-STAFFORD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****31

License Status

ACTIVE

Business

First Name

CHESKA

Last Name

AVERY-STAFFORD

Business Name

CHESKA AVERY-STAFFORD

Original Issue Date

11/14/2006

Effective Date

09/16/2024

Expiration Date

09/30/2027

City

WAUKEGAN

State

Zip

60087

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/16/2024