BUDI KUSNOTO Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000927

License Status

NOT RENEWED

Business

First Name

BUDI

Last Name

KUSNOTO

Business Name

BUDI KUSNOTO

Original Issue Date

06/05/1996

Effective Date

06/05/1996

Expiration Date

05/11/1999

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Orthodontics

Ever Disciplined

LastModifiedDate

07/12/2007