WILLIS BENNARD DAVIS 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

WILLIS BENNARD

Last Name

DAVIS

Business Name

WILLIS BENNARD DAVIS

Original Issue Date

10/19/1982

Effective Date

10/19/1982

Expiration Date

09/30/1984

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/13/2005