COLE W ANDERSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****90

License Status

NOT RENEWED

Business

First Name

COLE

Middle

Last Name

ANDERSON

Business Name

COLE W ANDERSON

Original Issue Date

01/08/2010

Effective Date

01/08/2010

Expiration Date

09/30/2012

City

SCHAUMBURG

State

Zip

60173

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012