REGINA B ROTKVICH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****46

License Status

NOT RENEWED

Business

First Name

REGINA

Middle

Last Name

ROTKVICH

Business Name

REGINA B ROTKVICH

Original Issue Date

07/17/2006

Effective Date

07/17/2006

Expiration Date

09/30/2009

City

CHICAGO

State

Zip

60623

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009