ANDRIANI ONGKORAHARDJO DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001135

License Status

NOT RENEWED

Business

First Name

ANDRIANI

Last Name

ONGKORAHARDJO

Suffix

DDS

Business Name

ANDRIANI ONGKORAHARDJO DDS

Original Issue Date

09/24/1998

Effective Date

09/24/1998

Expiration Date

06/30/1999

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatric Dentist

Ever Disciplined

LastModifiedDate

07/30/2018