BORIS BECKER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****34

License Status

NOT RENEWED

Business

First Name

BORIS

Last Name

BECKER

Suffix

DDS

Business Name

BORIS BECKER DDS

Original Issue Date

03/31/2000

Effective Date

06/04/2009

Expiration Date

09/30/2012

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

11/14/2012