PREDDIS L SULLIVAN Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****38

License Status

CANCELLED

Business

First Name

PREDDIS L

Last Name

SULLIVAN

Business Name

PREDDIS L SULLIVAN

Original Issue Date

04/07/1987

Effective Date

04/07/1987

Expiration Date

09/30/2004

City

AURORA

State

Zip

60504

County

DUPAGE

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/13/2005