MICHELLE L VAN DYKE DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****82

License Status

NOT RENEWED

Business

First Name

MICHELLE

Middle

Last Name

VAN DYKE

Suffix

DDS

Business Name

MICHELLE L VAN DYKE DDS

Original Issue Date

06/17/2004

Effective Date

06/17/2004

Expiration Date

09/30/2006

City

CHICAGO

State

Zip

60613

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2007