MADISON VICTORIA ALLEN Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****83

License Status

ACTIVE

Business

First Name

MADISON

Middle

VICTORIA

Last Name

ALLEN

Business Name

MADISON VICTORIA ALLEN

Original Issue Date

07/27/2019

Effective Date

07/08/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60646

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/08/2024