SHANNON MARIE MOLLOY DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****63

License Status

NOT RENEWED

Business

First Name

SHANNON MARIE

Last Name

MOLLOY

Suffix

DDS

Business Name

SHANNON MARIE MOLLOY DDS

Original Issue Date

11/07/1996

Effective Date

11/07/1996

Expiration Date

09/30/2002

City

EVANSTON

State

Zip

60201

County

COOK

Controlled Substance Schedule

IV V

Ever Disciplined

LastModifiedDate

10/17/2005