WALTER D ANDRADA 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

WALTER D

Last Name

ANDRADA

Business Name

WALTER D ANDRADA

Original Issue Date

11/18/1991

Effective Date

11/18/1991

Expiration Date

09/30/1994

City

CHICAGO

State

Zip

60641

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005