SHIRLEY LOUISE BURT-CHRISHON 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

SHIRLEY

Middle

LOUISE

Last Name

BURT-CHRISHON

Business Name

SHIRLEY LOUISE BURT-CHRISHON

Original Issue Date

10/19/1982

Effective Date

10/19/1982

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