THOMAS ANDRE ENDICOTT 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

THOMAS

Middle

ANDRE

Last Name

ENDICOTT

Business Name

THOMAS ANDRE ENDICOTT

Original Issue Date

06/13/2005

Effective Date

05/04/2010

Expiration Date

09/30/2012

City

ELGIN

State

Zip

60120

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012

Case Number

2005006060

Action

Suspension

Discipline Start Date

06/01/2010

Discipline Reason

for fraud in procuring his Illinois Controlled Substance license.