ANN MA MAST Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****44

License Status

NOT RENEWED

Business

First Name

ANN

Middle

Last Name

MAST

Business Name

ANN MA MAST

Original Issue Date

05/11/2017

Effective Date

05/11/2017

Expiration Date

09/30/2018

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018