KEVIN D AN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001228

License Status

NOT RENEWED

Business

First Name

KEVIN

Middle

Last Name

Suffix

DMD

Business Name

KEVIN D AN DMD

Original Issue Date

06/29/2000

Effective Date

06/29/2000

Expiration Date

06/30/2001

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005