DONALD EDGAR KELLOGG Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****79

License Status

NOT RENEWED

Business

First Name

DONALD EDGAR

Last Name

KELLOGG

Business Name

DONALD EDGAR KELLOGG

Original Issue Date

01/01/1998

Expiration Date

06/01/1982

City

CHICAGO

State

Zip

60643

County

COOK

Controlled Substance Schedule

III IV

Ever Disciplined

LastModifiedDate

10/13/2005