NICOLE SOPHIE JOHNSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000996

License Status

NOT RENEWED

Business

Title

DDS

First Name

NICOLE

Middle

SOPHIE

Last Name

JOHNSON

Business Name

NICOLE SOPHIE JOHNSON DDS

Original Issue Date

12/11/2017

Effective Date

08/16/2018

Expiration Date

01/31/2022

City

CHICAGO

State

Zip

60067

County

COOK

Specialty/Qualifier

CONSCIOUS SEDATION, PARENTERAL

Ever Disciplined

LastModifiedDate

05/09/2022