RANDALL REX CALVERT Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****78

License Status

NOT RENEWED

Business

First Name

RANDALL REX

Last Name

CALVERT

Business Name

RANDALL REX CALVERT

Original Issue Date

11/13/1985

Effective Date

11/13/1985

Expiration Date

09/30/1986

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005