JEFFREY RICHARD BLANKSHAIN 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

JEFFREY RICHARD

Last Name

BLANKSHAIN

Suffix

DDS

Business Name

JEFFREY RICHARD BLANKSHAIN DDS

Original Issue Date

01/01/1998

Effective Date

10/13/2021

Expiration Date

09/30/2024

City

CHICAGO

State

Zip

60707

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025