TRENEICE L MANGRAM 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

TRENEICE

Middle

Last Name

MANGRAM

Suffix

DDS

Business Name

TRENEICE L MANGRAM DDS

Original Issue Date

04/27/2004

Effective Date

09/02/2024

Expiration Date

09/30/2027

City

CHICAGO HEIGHTS

State

Zip

60411

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/02/2024