ANASTASIA MARIE HAUPT DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****41

License Status

NOT RENEWED

Business

Title

DDS

First Name

ANASTASIA

Middle

MARIE

Last Name

HAUPT

Business Name

ANASTASIA MARIE HAUPT DDS

Original Issue Date

06/18/2012

Effective Date

06/19/2018

Expiration Date

01/31/2022

City

EVANSTON

State

Zip

60201

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022