DONNA J KOCIM SAMONSKI Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****32

License Status

NOT RENEWED

Business

First Name

DONNA J

Last Name

KOCIM SAMONSKI

Business Name

DONNA J KOCIM SAMONSKI

Original Issue Date

12/08/1982

Effective Date

06/25/2018

Expiration Date

01/31/2022

City

ORLAND PARK

State

Zip

60462

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022