MICHAEL WILLIAM WONG DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****37

License Status

NOT RENEWED

Business

Title

DMD

First Name

MICHAEL

Middle

WILLIAM

Last Name

WONG

Business Name

MICHAEL WILLIAM WONG DMD

Original Issue Date

05/01/2014

Effective Date

01/22/2016

Expiration Date

09/30/2018

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018