JASON T DIFANI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****14

License Status

NOT RENEWED

Business

Title

DDS

First Name

JASON

Middle

Last Name

DIFANI

Business Name

JASON T DIFANI DDS

Original Issue Date

07/15/2009

Effective Date

05/03/2013

Expiration Date

09/30/2015

City

RIVERDALE

State

Zip

60827

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016