DANIEL S VAN VOLKENBURGH DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****52

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

Last Name

VAN VOLKENBURGH

Suffix

DDS

Business Name

DANIEL S VAN VOLKENBURGH DDS

Original Issue Date

08/29/2000

Effective Date

08/29/2000

Expiration Date

09/30/2004

City

CHICAGO

State

Zip

60647

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005