ANDRE JAMES LONGO Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****88

License Status

NOT RENEWED

Business

First Name

ANDRE JAMES

Last Name

LONGO

Business Name

ANDRE JAMES LONGO

Original Issue Date

01/01/1998

Expiration Date

09/30/1998

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

10/13/2005