STEPHANIE HAEYOUNG OH DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****35

License Status

NOT RENEWED

Business

Title

DMD

First Name

STEPHANIE

Middle

HAEYOUNG

Last Name

Business Name

STEPHANIE HAEYOUNG OH DMD

Original Issue Date

08/04/2015

Effective Date

06/12/2018

Expiration Date

01/31/2022

City

PEORIA

State

Zip

61615

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022