EDISON A ISHAYA Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****03

License Status

ACTIVE

Business

First Name

EDISON

Middle

Last Name

ISHAYA

Business Name

EDISON A ISHAYA

Original Issue Date

04/28/1998

Effective Date

10/01/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60647

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/16/2024