ANGIE SAMUEL DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****85

License Status

NOT RENEWED

Business

First Name

ANGIE

Last Name

SAMUEL

Suffix

DDS

Business Name

ANGIE SAMUEL DDS

Original Issue Date

06/30/2009

Effective Date

06/30/2009

Expiration Date

09/30/2012

City

BEACH PARK

State

Zip

60099

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012