JOHN MICHAEL GREEN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****80

License Status

NOT RENEWED

Business

First Name

JOHN MICHAEL

Last Name

GREEN

Business Name

JOHN MICHAEL GREEN

Original Issue Date

01/01/1998

Effective Date

07/05/2012

Expiration Date

09/30/2015

City

CHICAGO RIDGE

State

Zip

60415

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016