THEODORE J BORRIS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****61

License Status

CANCELLED

Business

First Name

THEODORE J

Last Name

BORRIS

Business Name

THEODORE J BORRIS

Original Issue Date

09/24/1982

Effective Date

09/24/1982

Expiration Date

09/30/1984

City

OAK PARK

State

Zip

60302

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005