DANIEL GEORGE ELLENZ DDS - Dentist License in Wisconsin | # 31*****59

DANIEL GEORGE ELLENZ DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****59

License Status

NOT RENEWED

Business

N

First Name

DANIEL GEORGE

Last Name

ELLENZ

Suffix

DDS

Business Name

DANIEL GEORGE ELLENZ DDS

Original Issue Date

11/04/1981

Effective Date

11/04/1981

Expiration Date

09/30/1996

State

WI

Controlled Substance Schedule

II III IV V

Ever Disciplined

N

LastModifiedDate

10/13/2005