DREW D FORQUER DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****56

License Status

CANCELLED

Business

First Name

DREW D

Last Name

FORQUER

Suffix

DDS

Business Name

DREW D FORQUER DDS

Original Issue Date

09/04/2003

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

CHICAGO

State

Zip

60631

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/04/2009

Case Number

2009001993

Action

Suspension

Discipline Start Date

03/23/2012

Discipline Reason

due to a conviction of two counts of Aggravated Driving Under the Influence of Alcohol.