JULIE ANNE BACON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****33

License Status

NOT RENEWED

Business

First Name

JULIE

Middle

ANNE

Last Name

BACON

Business Name

JULIE ANNE BACON

Original Issue Date

08/26/2002

Effective Date

08/15/2012

Expiration Date

09/30/2015

City

ELMHURST

State

Zip

60126

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016