KIP CHARLES OLDACRE 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

KIP CHARLES

Last Name

OLDACRE

Business Name

KIP CHARLES OLDACRE

Original Issue Date

10/14/1982

Effective Date

10/14/1982

Expiration Date

09/30/1984

City

CHICAGO

State

Zip

60607

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005