AMY M VANFOSSEN DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****76

License Status

ACTIVE

Business

First Name

AMY

Middle

Last Name

VANFOSSEN

Suffix

DDS

Business Name

AMY M VANFOSSEN DDS

Original Issue Date

06/11/2004

Effective Date

05/23/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60602

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/23/2024