DR. IRENE T. THEODORE, DDS
Dentist at Peterson Ave, Chicago, IL

License number
Illinois 019020903
Category
Dentist
Type
General Practice
Address
Address
4200 W Peterson Ave SUITE 136, Chicago, IL 60646
Phone
(773) 286-5286
(773) 286-5331 (Fax)
National Provider ID: 1871756767
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about IRENE T. THEODORE at bizstanding.com

IRENE T. THEODORE, D.D.S., LTD

Chicago, IL 60646

Status:
Inactive
Registration:
Jul 19, 1989
State ID:
55601186
Business type:
Domestic Bca
Expiration:
Perpetual
Agent:
Irene T Theodore Dds Ltd,4200 W Peterson STE 136, Chicago, IL 60646 (Physical)

Professional information

Irene T Theodore Photo 1

Dr. Irene T Theodore, Chicago IL - DDS (Doctor of Dental Surgery)
Specialties:
Dentistry
Address:
4200 W Peterson Ave STE 136, Chicago 60646
(773) 286-5286 (Phone), (773) 286-5331 (Fax)
Languages:
English

Dentist licenses in Illinois










Other Dentists licenses in Illinois