SUSAN G PENNISTON Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****79

License Status

CANCELLED

Business

First Name

SUSAN G

Last Name

PENNISTON

Business Name

SUSAN G PENNISTON

Original Issue Date

09/27/1982

Effective Date

09/27/1982

Expiration Date

09/30/1992

City

CHICAGO

State

Zip

60606

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005