BIANCA C CLARK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****56

License Status

NOT RENEWED

Business

Title

DDS

First Name

BIANCA

Middle

Last Name

CLARK

Business Name

BIANCA C CLARK DDS

Original Issue Date

10/07/2020

Effective Date

10/07/2020

Expiration Date

01/31/2022

City

CHICAGO

State

Zip

60607

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022