MICHAEL STEVEN HENDERSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****42

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

STEVEN

Last Name

HENDERSON

Business Name

MICHAEL STEVEN HENDERSON

Original Issue Date

11/17/2011

Effective Date

07/10/2012

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60643

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016