PATRICIA A GALLA BENCA 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

PATRICIA A GALLA

Last Name

BENCA

Business Name

PATRICIA A GALLA BENCA

Original Issue Date

02/07/1983

Effective Date

02/07/1983

Expiration Date

09/30/1986

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005