BARRY MARK NATHANSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****39

License Status

NOT RENEWED

Business

First Name

BARRY MARK

Last Name

NATHANSON

Suffix

DDS

Business Name

BARRY MARK NATHANSON DDS

Original Issue Date

01/01/1998

Effective Date

09/14/2009

Expiration Date

09/30/2012

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012