KENNETH ARTHUR JOHNSON Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****11

License Status

CANCELLED

Business

First Name

KENNETH ARTHUR

Last Name

JOHNSON

Business Name

KENNETH ARTHUR JOHNSON

Original Issue Date

09/26/1988

Effective Date

09/26/1988

Expiration Date

09/30/1992

City

CHICAGO

State

Zip

60625

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005