SHANNA LEIGH SPINA DMD 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

SHANNA

Middle

LEIGH

Last Name

SPINA

Suffix

DMD

Business Name

SHANNA LEIGH SPINA DMD

Original Issue Date

05/25/1999

Effective Date

05/25/1999

Expiration Date

09/30/2004

City

CHICAGO

State

Zip

60646

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005