DAVID J STORM Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****12

License Status

ACTIVE

Business

First Name

DAVID J

Last Name

STORM

Business Name

DAVID J STORM

Original Issue Date

03/22/1984

Effective Date

08/13/2024

Expiration Date

09/30/2027

City

SOUTH CHICAGO HEIGHT

State

Zip

60411

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/13/2024