TIFFANY VENITA TOWNSEL Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****57

License Status

ACTIVE

Business

First Name

TIFFANY

Middle

VENITA

Last Name

TOWNSEL

Business Name

TIFFANY VENITA TOWNSEL

Original Issue Date

09/11/2017

Effective Date

07/15/2024

Expiration Date

09/30/2027

City

RICHTON PARK

State

Zip

60471

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/15/2024