SANDRA S SONG DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****03

License Status

NOT RENEWED

Business

Title

DDS

First Name

SANDRA

Middle

Last Name

SONG

Business Name

SANDRA S SONG DDS

Original Issue Date

08/17/2017

Effective Date

08/17/2017

Expiration Date

09/30/2018

City

AURORA

State

Zip

60504

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018