JILL H BASKIN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****77

License Status

NOT RENEWED

Business

First Name

JILL H

Last Name

BASKIN

Business Name

JILL H BASKIN

Original Issue Date

09/15/1983

Effective Date

09/15/1983

Expiration Date

09/30/1990

City

RIVER FOREST

State

Zip

60305

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005