IRENE T THEODORE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****72

License Status

NOT RENEWED

Business

First Name

IRENE T

Last Name

THEODORE

Business Name

IRENE T THEODORE

Original Issue Date

11/02/1987

Effective Date

11/20/2021

Expiration Date

09/30/2024

City

CHICAGO

State

Zip

60646

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025