NUNYA PONGO IRVINE DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****91

License Status

NOT RENEWED

Business

First Name

NUNYA

Middle

PONGO

Last Name

IRVINE

Suffix

DMD

Business Name

NUNYA PONGO IRVINE DMD

Original Issue Date

07/25/2007

Effective Date

09/08/2015

Expiration Date

09/30/2018

City

GLENWOOD

State

Zip

60425

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018