LINORA NISSAN DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****32

License Status

ACTIVE

Business

Title

DMD

First Name

LINORA

Last Name

NISSAN

Business Name

LINORA NISSAN DMD

Original Issue Date

09/15/2020

Effective Date

09/23/2024

Expiration Date

09/30/2027

City

MORTON GROVE

State

Zip

60053

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/23/2024