DAVID A ANDERSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****40

License Status

NOT RENEWED

Business

First Name

DAVID A

Last Name

ANDERSON

Suffix

DDS

Business Name

DAVID A ANDERSON DDS

Original Issue Date

12/29/1988

Effective Date

12/29/1988

Expiration Date

09/30/1990

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005