ERIC P SMYTH 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

ERIC P

Last Name

SMYTH

Business Name

ERIC P SMYTH

Original Issue Date

10/20/1986

Effective Date

08/17/2009

Expiration Date

09/30/2012

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012