MICHAEL W HENNEMAN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****60

License Status

NOT RENEWED

Business

First Name

MICHAEL W

Last Name

HENNEMAN

Suffix

DDS

Business Name

MICHAEL W HENNEMAN DDS

Original Issue Date

01/01/1998

Expiration Date

01/01/1998

City

DEKALB

State

Zip

60115

County

DEKALB

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005