JUSTIN SONG DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****43

License Status

ACTIVE

Business

Title

DMD

First Name

JUSTIN

Last Name

SONG

Business Name

JUSTIN SONG DMD

Original Issue Date

07/01/2022

Effective Date

08/02/2024

Expiration Date

09/30/2027

City

WOODSTOCK

State

Zip

60098

County

MCHENRY

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/02/2024