IMMI SONG DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000536

License Status

NOT RENEWED

Business

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

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Orthodontics

Ever Disciplined

LastModifiedDate

10/12/2005