KINESHIA ROARK DMD 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

KINESHIA

Last Name

ROARK

Suffix

DMD

Business Name

KINESHIA ROARK DMD

Original Issue Date

09/19/2002

Effective Date

06/04/2009

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60653

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012