ANNA SEUNG EUN CHUNG DDS 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

ANNA

Middle

SEUNG EUN

Last Name

CHUNG

Suffix

DDS

Business Name

ANNA SEUNG EUN CHUNG DDS

Original Issue Date

05/13/2014

Effective Date

05/13/2014

Expiration Date

09/30/2015

City

MATTOON

State

Zip

61938

County

COLES

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016