ROSEMARIE CHIONG TAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****87

License Status

NOT RENEWED

Business

First Name

ROSEMARIE

Middle

CHIONG

Last Name

TAN

Business Name

ROSEMARIE CHIONG TAN

Original Issue Date

07/27/2006

Effective Date

09/03/2009

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60607

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012