TOMMY ROSE DDS 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

TOMMY

Last Name

ROSE

Suffix

DDS

Business Name

TOMMY ROSE DDS

Original Issue Date

02/01/1996

Effective Date

02/01/1996

Expiration Date

09/30/1996

City

CHICAGO

State

Zip

60623

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005