DUSTIN MICHAEL DAVIS DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001837

License Status

CANCELLED

Business

Title

DDS

First Name

DUSTIN

Middle

MICHAEL

Last Name

DAVIS

Business Name

DUSTIN MICHAEL DAVIS DDS

Original Issue Date

06/07/2012

Effective Date

07/01/2012

Expiration Date

06/30/2014

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatric Dentist

Ever Disciplined

LastModifiedDate

07/30/2018