CHAD LOUIS WAGSTAFF DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****81

License Status

NOT RENEWED

Business

First Name

CHAD

Middle

LOUIS

Last Name

WAGSTAFF

Suffix

DDS

Business Name

CHAD LOUIS WAGSTAFF DDS

Original Issue Date

09/25/2000

Effective Date

08/09/2012

Expiration Date

09/30/2015

City

BARTLETT

State

Zip

60103

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016