MARDI A TINGZON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****62

License Status

NOT RENEWED

Business

First Name

MARDI A

Last Name

TINGZON

Suffix

DDS

Business Name

MARDI A TINGZON DDS

Original Issue Date

10/24/1991

Effective Date

10/24/1991

Expiration Date

09/30/1992

City

OAK BROOK

State

Zip

60521

County

DUPAGE

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/13/2005