STEVEN B RAPHAEL 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

STEVEN

Middle

Last Name

RAPHAEL

Suffix

DDS

Business Name

STEVEN B RAPHAEL DDS

Original Issue Date

03/23/2010

Effective Date

03/23/2010

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012