KIMBERLEY M H BOLDEN Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****48

License Status

ACTIVE

Business

First Name

KIMBERLEY

Middle

M H

Last Name

BOLDEN

Business Name

KIMBERLEY M H BOLDEN

Original Issue Date

10/25/1984

Effective Date

05/02/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60605

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/02/2024