ANDY J MALCOLM DDS - Dentist License in Illinois | # 137000703

ANDY J MALCOLM DDS

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000703

License Status

ACTIVE

Business

N

First Name

ANDY

Middle

J

Last Name

MALCOLM

Suffix

DDS

Business Name

ANDY J MALCOLM DDS

Original Issue Date

08/08/2007

Effective Date

05/06/2024

Expiration Date

09/30/2027

State

IL

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

N

LastModifiedDate

05/06/2024