ANDREA M ADAM Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****80

License Status

NOT RENEWED

Business

First Name

ANDREA M

Last Name

ADAM

Business Name

ANDREA M ADAM

Original Issue Date

09/17/1984

Effective Date

09/17/1984

Expiration Date

09/30/2002

City

ST CHARLES

State

Zip

60175

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005