CAROLYN PETERS LARSEN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****87

License Status

NOT RENEWED

Business

First Name

CAROLYN PETERS

Last Name

LARSEN

Business Name

CAROLYN PETERS LARSEN

Original Issue Date

08/30/1991

Effective Date

08/30/1991

Expiration Date

09/30/1992

City

HANOVER PARK

State

Zip

60103

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005