MARY S RUNNER DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****84

License Status

NOT RENEWED

Business

First Name

MARY S

Last Name

RUNNER

Suffix

DDS

Business Name

MARY S RUNNER DDS

Original Issue Date

09/29/1986

Effective Date

09/29/1986

Expiration Date

09/30/1996

City

CHICAGO

State

Zip

60615

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005