MARTHA HA DDS Dentist License verification

Business Entity

INOPERATIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000874

License Status

INOPERATIVE

Business

Title

DDS

First Name

MARTHA

Last Name

Business Name

MARTHA HA DDS

Original Issue Date

09/06/2013

Effective Date

09/17/2015

Expiration Date

09/30/2018

City

CHICAGO

State

Zip

60610

County

COOK

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

06/07/2018