NICOLE SOPHIE JOHNSON DDS - Dentist License in Illinois | # 137000996

NICOLE SOPHIE JOHNSON DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000996

License Status

NOT RENEWED

Business

N

Title

DDS

First Name

NICOLE

Middle

SOPHIE

Last Name

JOHNSON

Business Name

NICOLE SOPHIE JOHNSON DDS

Original Issue Date

12/11/2017

Effective Date

08/16/2018

Expiration Date

01/31/2022

State

IL

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

N

LastModifiedDate

05/09/2022