JINGYUAN FAN DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****51

License Status

ACTIVE

Business

Title

DDS

First Name

JINGYUAN

Last Name

FAN

Business Name

JINGYUAN FAN DDS

Original Issue Date

08/11/2016

Effective Date

06/05/2024

Expiration Date

09/30/2027

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/05/2024