RYAN MASAO MIZUMOTO DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019028088

License Status

NOT RENEWED

Business

Title

DMD

First Name

RYAN

Middle

MASAO

Last Name

MIZUMOTO

Business Name

RYAN MASAO MIZUMOTO DMD

Original Issue Date

07/16/2009

Effective Date

07/16/2009

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60642

County

COOK

Ever Disciplined

LastModifiedDate

11/14/2012