JOSHUA D KRISTIANSEN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****74

License Status

NOT RENEWED

Business

First Name

JOSHUA

Middle

Last Name

KRISTIANSEN DMD

Business Name

JOSHUA D KRISTIANSEN DMD

Original Issue Date

08/10/2010

Effective Date

08/10/2010

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60604

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012