AMY M VANFOSSEN DDS Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001412

License Status

EXPIRED

Business

First Name

AMY

Middle

Last Name

VANFOSSEN

Suffix

DDS

Business Name

AMY M VANFOSSEN DDS

Original Issue Date

06/26/2003

Effective Date

06/26/2003

Expiration Date

06/30/2004

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005