MERWIN BERYL ROSEN 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

First Name

MERWIN BERYL

Last Name

ROSEN

Suffix

DDS

Business Name

MERWIN BERYL ROSEN DDS

Original Issue Date

07/17/1992

Effective Date

07/17/1992

Expiration Date

09/30/2004

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005