TINA TAN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****16

License Status

NOT RENEWED

Business

First Name

TINA

Last Name

TAN

Suffix

DMD

Business Name

TINA TAN DMD

Original Issue Date

06/24/1986

Effective Date

08/07/2015

Expiration Date

09/30/2018

City

MT PROSPECT

State

Zip

60056

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018