R RANDY MIKOS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****79

License Status

ACTIVE

Business

First Name

Middle

RANDY

Last Name

MIKOS

Business Name

R RANDY MIKOS

Original Issue Date

07/23/1982

Effective Date

06/04/2024

Expiration Date

09/30/2027

City

SKOKIE

State

Zip

60077

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/04/2024