KELLY ANN MCGOWAN JOHNSON DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****02

License Status

ACTIVE

Business

Title

DMD

First Name

KELLY

Middle

ANN

Last Name

MCGOWAN JOHNSON

Business Name

KELLY ANN MCGOWAN JOHNSON DMD

Original Issue Date

11/05/2021

Effective Date

08/27/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60655

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/27/2024