JONATHAN PETER MONTAG DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****35

License Status

CANCELLED

Business

First Name

JONATHAN

Middle

PETER

Last Name

MONTAG

Suffix

DDS

Business Name

JONATHAN PETER MONTAG DDS

Original Issue Date

10/26/2000

Effective Date

10/26/2000

Expiration Date

09/30/2002

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

10/17/2005