STANSBY A PORTER Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****41

License Status

NOT RENEWED

Business

First Name

STANSBY A

Last Name

PORTER

Business Name

STANSBY A PORTER

Original Issue Date

11/23/1987

Effective Date

09/28/2009

Expiration Date

09/30/2012

City

SOUTH HOLLAND

State

Zip

60473

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012