KELLY ANN MCGOWAN JOHNSON DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****28

License Status

NOT RENEWED

Business

Title

DMD

First Name

KELLY

Middle

ANN

Last Name

MCGOWAN JOHNSON

Business Name

KELLY ANN MCGOWAN JOHNSON DMD

Original Issue Date

05/24/2016

Effective Date

10/03/2018

Expiration Date

01/31/2022

City

CHICAGO

State

Zip

60655

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022