PHILIP GREEN 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

PHILIP

Last Name

GREEN

Suffix

DDS

Business Name

PHILIP GREEN DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1988

City

CHICAGO

State

Zip

60602

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005

Case Number

1987002397

Action

Revocation

Discipline Start Date

11/25/1988