CAMERON L PANGBORN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****43

License Status

NOT RENEWED

Business

First Name

CAMERON

Middle

Last Name

PANGBORN

Suffix

DDS

Business Name

CAMERON L PANGBORN DDS

Original Issue Date

05/11/2000

Effective Date

05/11/2000

Expiration Date

09/30/2002

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005