MICHAEL Y MATSUMOTO DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****25

License Status

NOT RENEWED

Business

First Name

MICHAEL Y

Last Name

MATSUMOTO

Suffix

DDS

Business Name

MICHAEL Y MATSUMOTO DDS

Original Issue Date

01/11/1990

Effective Date

01/11/1990

Expiration Date

09/30/1996

City

CHICAGO

State

Zip

60602

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005