MIA NEESHELE STONE DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****00

License Status

NOT RENEWED

Business

Title

DMD

First Name

MIA

Middle

NEESHELE

Last Name

STONE

Business Name

MIA NEESHELE STONE DMD

Original Issue Date

10/06/2017

Effective Date

07/05/2018

Expiration Date

01/31/2022

City

ZION

State

Zip

60099

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/18/2023