BEN JAMES WALLACE JR DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****57

License Status

ACTIVE

Business

First Name

BEN JAMES

Last Name

WALLACE JR

Suffix

DDS

Business Name

BEN JAMES WALLACE JR DDS

Original Issue Date

01/21/1997

Effective Date

07/23/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60628

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/23/2024