PETER SUNG JONG CHANG 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

PETER

Middle

SUNG JONG

Last Name

CHANG

Business Name

PETER SUNG JONG CHANG

Original Issue Date

09/22/1992

Effective Date

09/22/1992

Expiration Date

09/30/1994

City

BUFFALO GROVE

State

Zip

60089

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005