JOHN M VICKERY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****89

License Status

NOT RENEWED

Business

First Name

JOHN M

Last Name

VICKERY

Business Name

JOHN M VICKERY

Original Issue Date

01/17/1991

Effective Date

01/17/1991

Expiration Date

09/30/1994

City

CHICAGO

State

Zip

60659

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005