AMY ELLIS GREEN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000791

License Status

NOT RENEWED

Business

First Name

AMY ELLIS

Last Name

GREEN

Suffix

DMD

Business Name

AMY ELLIS GREEN DMD

Original Issue Date

07/14/1994

Effective Date

07/14/1994

Expiration Date

06/30/1996

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

Pediatric Dentist

Ever Disciplined

LastModifiedDate

07/30/2018