BERNIE MONTANA H JON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****23

License Status

NOT RENEWED

Business

First Name

BERNIE MONTANA H

Last Name

JON

Suffix

DDS

Business Name

BERNIE MONTANA H JON DDS

Original Issue Date

03/13/2000

Effective Date

03/13/2000

Expiration Date

09/30/2004

City

CHICAGO

State

Zip

60655

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005