SCOTT EVAN PROSE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****45

License Status

NOT RENEWED

Business

First Name

SCOTT

Middle

EVAN

Last Name

PROSE

Suffix

DDS

Business Name

SCOTT EVAN PROSE DDS

Original Issue Date

08/30/1985

Effective Date

08/30/1985

Expiration Date

09/30/1992

City

NORTHBROOK

State

Zip

60062

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005