EDWARD J MATSUMOTO DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****41

License Status

ACTIVE

Business

First Name

EDWARD J

Last Name

MATSUMOTO

Suffix

DDS

Business Name

EDWARD J MATSUMOTO DDS

Original Issue Date

08/30/1991

Effective Date

10/01/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60640

County

COOK

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

12/23/2024