STUART GEORGE PETTIJOHN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****47

License Status

NOT RENEWED

Business

First Name

STUART

Middle

GEORGE

Last Name

PETTIJOHN

Suffix

DDS

Business Name

STUART GEORGE PETTIJOHN DDS

Original Issue Date

05/25/2011

Effective Date

08/21/2015

Expiration Date

09/30/2018

City

CHICAGO

State

Zip

60618

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018