MIGUEL ANGEL ORTIZ DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****98

License Status

NOT RENEWED

Business

Title

DMD

First Name

MIGUEL

Middle

ANGEL

Last Name

ORTIZ

Business Name

MIGUEL ANGEL ORTIZ DMD

Original Issue Date

07/17/2014

Effective Date

09/30/2015

Expiration Date

09/30/2018

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018