EZRA M CHAN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000245

License Status

NOT RENEWED

Business

First Name

EZRA

Middle

Last Name

CHAN

Suffix

DDS

Business Name

EZRA M CHAN DDS

Original Issue Date

06/12/1990

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

CHICAGO

State

Zip

60605

County

COOK

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

LastModifiedDate

11/04/2009

Case Number

2009006418

Action

Refuse To Renew

Discipline Start Date

08/27/2009

Discipline Reason

for failure to respond to a continuing education audit.