RALPH DAVID BERENSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****74

License Status

NOT RENEWED

Business

First Name

RALPH DAVID

Last Name

BERENSON

Business Name

RALPH DAVID BERENSON

Original Issue Date

01/01/1998

Expiration Date

09/30/1990

City

DEERFIELD

State

Zip

60015

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005