WAYNE LEE BERRY Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****99

License Status

NOT RENEWED

Business

First Name

WAYNE LEE

Last Name

BERRY

Business Name

WAYNE LEE BERRY

Original Issue Date

09/20/1985

Effective Date

09/20/1985

Expiration Date

09/30/1986

City

CHICAGO

State

Zip

60624

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005