ELIZABETH TERESA KALLIATH-MOORE Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****78

License Status

ACTIVE

Business

First Name

ELIZABETH

Middle

TERESA

Last Name

KALLIATH-MOORE

Business Name

ELIZABETH TERESA KALLIATH-MOORE

Original Issue Date

08/19/2014

Effective Date

08/08/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/08/2024