SHANDRA LOLITA BUNDY-SMITH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****69

License Status

NOT RENEWED

Business

First Name

SHANDRA LOLITA

Last Name

BUNDY-SMITH

Business Name

SHANDRA LOLITA BUNDY-SMITH

Original Issue Date

03/15/1995

Effective Date

03/15/1995

Expiration Date

09/30/1996

City

CHICAGO

State

Zip

60619

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005