DAVID ALFRED DANIELS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****78

License Status

CANCELLED

Business

First Name

DAVID ALFRED

Last Name

DANIELS

Business Name

DAVID ALFRED DANIELS

Original Issue Date

01/01/1998

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

LONG GROVE

State

Zip

60047

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/04/2009