MARLENE T ADAMS 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

MARLENE T

Last Name

ADAMS

Business Name

MARLENE T ADAMS

Original Issue Date

07/13/2007

Effective Date

10/09/2009

Expiration Date

09/30/2012

City

ROCKFORD

State

Zip

61102

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

11/14/2012