SAMUEL JON WILSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019012279

License Status

NOT RENEWED

Business

First Name

SAMUEL

Middle

JON

Last Name

WILSON

Suffix

DDS

Business Name

SAMUEL JON WILSON DDS

Original Issue Date

07/25/1963

Effective Date

07/25/1963

Expiration Date

09/30/2004

City

CHICAGO

State

Zip

60628

County

COOK

Ever Disciplined

LastModifiedDate

01/17/2007

Case Number

1998017662

Action

Reprimand

Discipline Start Date

07/24/2002

Discipline Reason

Failed to properly diagnose a fractured jaw and retained roots post-operatively, and failed to refer the patient to a specialist for treatment.