REGINALD ODOM Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****48

License Status

ACTIVE

Business

First Name

REGINALD

Last Name

ODOM

Business Name

REGINALD ODOM

Original Issue Date

01/26/1989

Effective Date

09/17/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60632

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/17/2024