LAURIE ELLEN SUSARCHICK-STACHE DDS Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018002072

License Status

EXPIRED

Business

Title

DDS

First Name

LAURIE

Middle

ELLEN

Last Name

SUSARCHICK-STACHE

Business Name

LAURIE ELLEN SUSARCHICK-STACHE DDS

Original Issue Date

06/20/2018

Effective Date

08/13/2018

Expiration Date

05/16/2021

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Orthodontics

Ever Disciplined

LastModifiedDate

07/20/2021