KESIA KEIKO ASAMI DE SOUZA Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****25

License Status

ACTIVE

Business

First Name

KESIA KEIKO

Last Name

ASAMI DE SOUZA

Business Name

KESIA KEIKO ASAMI DE SOUZA

Original Issue Date

06/02/2021

Effective Date

05/07/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/07/2024