TYRAN E JOHNSON DDS - Dentist License in Illinois | # 137000702

TYRAN E JOHNSON DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000702

License Status

NOT RENEWED

Business

N

Title

DDS

First Name

TYRAN

Middle

E

Last Name

JOHNSON

Business Name

TYRAN E JOHNSON DDS

Original Issue Date

08/08/2007

Effective Date

08/08/2007

Expiration Date

09/30/2009

State

IL

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

N

LastModifiedDate

11/04/2009