DAVID IRA KONICOV DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****79

License Status

NOT RENEWED

Business

First Name

DAVID IRA

Last Name

KONICOV

Suffix

DDS

Business Name

DAVID IRA KONICOV DDS

Original Issue Date

01/01/1998

Expiration Date

01/01/1998

City

CHICAGO

State

Zip

60644

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005