MIMI V JOHNSON Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****84

License Status

ACTIVE

Business

First Name

MIMI V

Last Name

JOHNSON

Business Name

MIMI V JOHNSON

Original Issue Date

03/18/1986

Effective Date

06/24/2024

Expiration Date

09/30/2027

City

BELLWOOD

State

Zip

60104

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/24/2024