STACEY MARIE TATRO DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****91

License Status

NOT RENEWED

Business

Title

DMD

First Name

STACEY

Middle

MARIE

Last Name

TATRO

Business Name

STACEY MARIE TATRO DMD

Original Issue Date

06/08/2016

Effective Date

06/12/2018

Expiration Date

01/31/2022

City

OAK LAWN

State

Zip

60453

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022