TAMMY M CHANG-MOTOOKA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000612

License Status

NOT RENEWED

Business

First Name

TAMMY

Middle

Last Name

CHANG-MOTOOKA

Business Name

TAMMY M CHANG-MOTOOKA

Original Issue Date

06/04/1992

Effective Date

06/04/1992

Expiration Date

06/30/1994

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Orthodontics

Ever Disciplined

LastModifiedDate

10/12/2005