MYLES RICHARD CLANCY DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****37

License Status

NOT RENEWED

Business

Title

DMD

First Name

MYLES

Middle

RICHARD

Last Name

CLANCY

Business Name

MYLES RICHARD CLANCY DMD

Original Issue Date

07/07/2016

Effective Date

07/07/2016

Expiration Date

09/30/2018

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018