LARISA BANDURA 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

LARISA

Last Name

BANDURA

Business Name

LARISA BANDURA

Original Issue Date

03/27/1985

Effective Date

10/22/2007

Expiration Date

09/30/2009

City

CHICAGO

State

Zip

60622

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009