PREDDIS L SULLIVAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****37

License Status

NOT RENEWED

Business

First Name

PREDDIS L

Last Name

SULLIVAN

Business Name

PREDDIS L SULLIVAN

Original Issue Date

04/01/1987

Effective Date

04/01/1987

Expiration Date

09/30/1988

City

CHICAGO

State

Zip

60628

County

COOK

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/13/2005