RANDALL OLIVA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****51

License Status

NOT RENEWED

Business

First Name

RANDALL

Last Name

OLIVA

Suffix

DDS

Business Name

RANDALL OLIVA DDS

Original Issue Date

08/02/1982

Effective Date

06/07/2018

Expiration Date

01/31/2022

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022