LAWRENCE NORMAN WALLACE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****67

License Status

NOT RENEWED

Business

First Name

LAWRENCE NORMAN

Last Name

WALLACE

Suffix

DDS

Business Name

LAWRENCE NORMAN WALLACE DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1998

City

DES PLAINES

State

Zip

60016

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005