NI VAN DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019031163

License Status

ACTIVE

Business

Title

DMD

First Name

Last Name

VAN

Business Name

NI VAN DMD

Original Issue Date

06/02/2017

Effective Date

05/25/2024

Expiration Date

09/30/2027

City

FRANKFORT

State

Zip

60423

County

WILL

Ever Disciplined

LastModifiedDate

05/25/2024