MOLLY PHYLLIS ERICSON DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****47

License Status

ACTIVE

Business

Title

DMD

First Name

MOLLY

Middle

PHYLLIS

Last Name

ERICSON

Business Name

MOLLY PHYLLIS ERICSON DMD

Original Issue Date

08/01/2014

Effective Date

09/04/2024

Expiration Date

09/30/2027

City

DOWNERS GROVE

State

Zip

60516

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/04/2024