SAGE JACKLYN VANANTWERP DMD Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018002039

License Status

EXPIRED

Business

First Name

SAGE

Middle

JACKLYN

Last Name

VANANTWERP

Suffix

DMD

Business Name

SAGE JACKLYN VANANTWERP DMD

Original Issue Date

06/21/2017

Effective Date

07/01/2017

Expiration Date

06/30/2018

City

MAYWOOD

State

Zip

60153

County

COOK

Ever Disciplined

LastModifiedDate

10/25/2018