RENEE ANNE WALL 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

RENEE ANNE

Last Name

WALL

Business Name

RENEE ANNE WALL

Original Issue Date

08/03/1983

Effective Date

08/03/1983

Expiration Date

09/30/1988

City

WILMETTE

State

Zip

60091

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005