SEAN MICHAEL MARTIN 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

Title

DMD

First Name

SEAN

Middle

MICHAEL

Last Name

MARTIN

Business Name

SEAN MICHAEL MARTIN DMD

Original Issue Date

11/17/2009

Effective Date

11/17/2009

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012