JEFFREY CHARLES GREEN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****83

License Status

NOT RENEWED

Business

First Name

JEFFREY CHARLES

Last Name

GREEN

Suffix

DDS

Business Name

JEFFREY CHARLES GREEN DDS

Original Issue Date

10/16/1987

Effective Date

10/16/1987

Expiration Date

09/30/1992

City

CHICAGO

State

Zip

60646

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005