NELLIE P GANNON DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****58

License Status

NOT RENEWED

Business

First Name

NELLIE

Middle

Last Name

GANNON DMD

Business Name

NELLIE P GANNON DMD

Original Issue Date

06/16/2023

Effective Date

06/16/2023

Expiration Date

09/30/2024

City

ORLAND PARK

State

Zip

60467

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025