MELISA L TILLNER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****72

License Status

NOT RENEWED

Business

Title

DDS

First Name

MELISA

Middle

Last Name

TILLNER

Business Name

MELISA L TILLNER DDS

Original Issue Date

09/15/2006

Effective Date

09/15/2006

Expiration Date

09/30/2009

City

CHICAGO

State

Zip

60632

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009