ROSS M JOHNSEN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****26

License Status

NOT RENEWED

Business

First Name

ROSS M

Last Name

JOHNSEN

Business Name

ROSS M JOHNSEN

Original Issue Date

09/22/1987

Effective Date

09/04/2012

Expiration Date

09/30/2015

City

GURNEE

State

Zip

60031

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016