KATIE EILEEN JOHNSTON DDS 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

KATIE

Middle

EILEEN

Last Name

JOHNSTON

Suffix

DDS

Business Name

KATIE EILEEN JOHNSTON DDS

Original Issue Date

02/06/2008

Effective Date

08/13/2009

Expiration Date

09/30/2012

City

ROUND LAKE BEACH

State

Zip

60073

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012