CARINA B CHAVEZ Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****95

License Status

NOT RENEWED

Business

First Name

CARINA

Middle

Last Name

CHAVEZ

Business Name

CARINA B CHAVEZ

Original Issue Date

08/21/1998

Effective Date

08/21/1998

Expiration Date

09/30/2006

City

ROSELLE

State

Zip

60172

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006