MICHAEL SMOLEN 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

MICHAEL

Last Name

SMOLEN

Business Name

MICHAEL SMOLEN

Original Issue Date

09/18/1983

Effective Date

09/18/1983

Expiration Date

09/30/1990

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005