JONATHAN PETER MONTAG DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001217

License Status

NOT RENEWED

Business

First Name

JONATHAN

Middle

PETER

Last Name

MONTAG

Suffix

DDS

Business Name

JONATHAN PETER MONTAG DDS

Original Issue Date

06/09/2000

Effective Date

06/09/2000

Expiration Date

06/30/2001

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005