DONALD SAMUEL CLEM III DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****58

License Status

NOT RENEWED

Business

First Name

DONALD

Middle

SAMUEL

Last Name

CLEM

Suffix

III DDS

Business Name

DONALD SAMUEL CLEM III DDS

Original Issue Date

01/01/1998

Expiration Date

06/01/1982

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005