KENNETH O JOHNSON Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****60

License Status

ACTIVE

Business

First Name

KENNETH O

Last Name

JOHNSON

Business Name

KENNETH O JOHNSON

Original Issue Date

11/05/1982

Effective Date

07/12/2024

Expiration Date

09/30/2027

City

SOUTH HOLLAND

State

Zip

60473

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/12/2024