SPENCER CHONG NICHOLSON Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****10

License Status

NOT RENEWED

Business

First Name

SPENCER

Middle

CHONG

Last Name

NICHOLSON

Business Name

SPENCER CHONG NICHOLSON

Original Issue Date

08/14/2001

Effective Date

09/26/2018

Expiration Date

01/31/2022

City

WHEATON

State

Zip

60189

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022