IMMI SONG DDS - Dentist License in Illinois | # 018000536

IMMI SONG DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000536

License Status

NOT RENEWED

Business

N

First Name

IMMI

Last Name

SONG

Suffix

DDS

Business Name

IMMI SONG DDS

Original Issue Date

06/05/1991

Effective Date

06/05/1991

Expiration Date

06/30/1993

State

IL

Specialty/Qualifier

Orthodontics

Ever Disciplined

N

LastModifiedDate

10/12/2005