CHARLYN RAPPA BRADSHAW DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****54

License Status

NOT RENEWED

Business

First Name

CHARLYN RAPPA

Last Name

BRADSHAW

Suffix

DMD

Business Name

CHARLYN RAPPA BRADSHAW DMD

Original Issue Date

05/02/1995

Effective Date

05/02/1995

Expiration Date

09/30/1996

City

CHICAGO

State

Zip

60632

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005