JACQUELINE G ROSEN DDS MS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****55

License Status

CANCELLED

Business

First Name

JACQUELINE G

Last Name

ROSEN DDS MS

Business Name

JACQUELINE G ROSEN DDS MS

Original Issue Date

06/12/1991

Effective Date

06/12/1991

Expiration Date

09/30/1992

City

BUFFALO GROVE

State

Zip

60089

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005