MIRANDA A ALBERT DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****93

License Status

NOT RENEWED

Business

First Name

MIRANDA

Middle

Last Name

ALBERT

Suffix

DDS

Business Name

MIRANDA A ALBERT DDS

Original Issue Date

06/22/2004

Effective Date

06/22/2004

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