DEO K PUN - Dentist License in Illinois | # 31*****44

DEO K PUN

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****44

License Status

NOT RENEWED

Business

N

First Name

DEO

Middle

K

Last Name

PUN

Business Name

DEO K PUN

Original Issue Date

10/18/2010

Effective Date

08/13/2012

Expiration Date

09/30/2015

City

STERLING

State

IL

Zip

61081

County

WHITESIDE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

02/08/2016