QIUJING SONG DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****97

License Status

ACTIVE

Business

Title

DMD

First Name

QIUJING

Last Name

SONG

Business Name

QIUJING SONG DMD

Original Issue Date

06/09/2016

Effective Date

09/26/2024

Expiration Date

09/30/2027

City

NAPERVILLE

State

Zip

60540

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2024