JASON CHANDLER PRIMAVERA DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001817

License Status

CANCELLED

Business

Title

DDS

First Name

JASON

Middle

CHANDLER

Last Name

PRIMAVERA

Business Name

JASON CHANDLER PRIMAVERA DDS

Original Issue Date

07/05/2011

Effective Date

07/01/2011

Expiration Date

06/30/2015

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

LastModifiedDate

07/05/2011