NICOLE SOPHIE JOHNSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****41

License Status

NOT RENEWED

Business

Title

DDS

First Name

NICOLE

Middle

SOPHIE

Last Name

JOHNSON

Business Name

NICOLE SOPHIE JOHNSON DDS

Original Issue Date

09/05/2017

Effective Date

08/16/2018

Expiration Date

01/31/2022

City

LAKE FOREST

State

Zip

60045

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022