KEVEN SCOTT HEROLD DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****92

License Status

NOT RENEWED

Business

First Name

KEVEN

Middle

SCOTT

Last Name

HEROLD

Suffix

DDS

Business Name

KEVEN SCOTT HEROLD DDS

Original Issue Date

10/17/2003

Effective Date

10/17/2003

Expiration Date

09/30/2006

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006