JESSICA MYTRANG NGUYEN DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****96

License Status

NOT RENEWED

Business

Title

DMD

First Name

JESSICA

Middle

MYTRANG

Last Name

NGUYEN

Business Name

JESSICA MYTRANG NGUYEN DMD

Original Issue Date

06/25/2013

Effective Date

06/25/2013

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016