CAROLYN FAY BELKE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****59

License Status

NOT RENEWED

Business

First Name

CAROLYN

Middle

FAY

Last Name

BELKE

Suffix

DDS

Business Name

CAROLYN FAY BELKE DDS

Original Issue Date

05/25/1999

Effective Date

05/25/1999

Expiration Date

09/30/2002

City

CHICAGO

State

Zip

60601

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005