DAVID FANG DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****24

License Status

NOT RENEWED

Business

First Name

DAVID

Last Name

FANG

Suffix

DDS

Business Name

DAVID FANG DDS

Original Issue Date

09/14/2004

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

CHICAGO

State

Zip

60639

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009