KEVIN M BOEHM DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****65

License Status

NOT RENEWED

Business

First Name

KEVIN M

Last Name

BOEHM

Suffix

DDS

Business Name

KEVIN M BOEHM DDS

Original Issue Date

10/25/1994

Effective Date

10/25/1994

Expiration Date

09/30/2000

City

WILLOW SPRINGS

State

Zip

60480

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005