SIRI CHANTHASALO DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****72

License Status

ACTIVE

Business

First Name

SIRI

Last Name

CHANTHASALO

Suffix

DDS

Business Name

SIRI CHANTHASALO DDS

Original Issue Date

07/12/2002

Effective Date

07/30/2024

Expiration Date

09/30/2027

City

ELGIN

State

Zip

60124

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/30/2024