MINDY MELIKA VAN 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

Title

DDS

First Name

MINDY

Middle

MELIKA

Last Name

VAN

Business Name

MINDY MELIKA VAN DDS

Original Issue Date

05/02/2012

Effective Date

05/02/2012

Expiration Date

09/30/2012

City

BOLINGBROOK

State

Zip

60440

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012