SEAYOON AN 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

Title

DMD

First Name

SEAYOON

Last Name

Business Name

SEAYOON AN DMD

Original Issue Date

09/25/2017

Effective Date

08/07/2018

Expiration Date

01/31/2022

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022