DIRK MICHAEL DONOVAN 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

DIRK

Middle

MICHAEL

Last Name

DONOVAN

Business Name

DIRK MICHAEL DONOVAN

Original Issue Date

10/29/2004

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

OAK BROOK

State

Zip

60523

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009