SCARLETT J WALSTON 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

SCARLETT

Middle

Last Name

WALSTON

Business Name

SCARLETT J WALSTON

Original Issue Date

11/15/2022

Effective Date

11/15/2022

Expiration Date

09/30/2024

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025