KATHERINE M FOX Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****36

License Status

NOT RENEWED

Business

First Name

KATHERINE M

Last Name

FOX

Business Name

KATHERINE M FOX

Original Issue Date

11/08/1990

Effective Date

11/08/1990

Expiration Date

09/30/1996

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005