MICHAEL STEVEN HENDERSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****91

License Status

NOT RENEWED

Business

First Name

MICHAEL

Middle

STEVEN

Last Name

HENDERSON

Business Name

MICHAEL STEVEN HENDERSON

Original Issue Date

11/09/2015

Effective Date

11/09/2015

Expiration Date

09/30/2018

City

SOUTH HOLLAND

State

Zip

60473

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018