EDWIN THADDEUS KAPUSTKA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019010130

License Status

NOT RENEWED

Business

First Name

EDWIN THADDEUS

Last Name

KAPUSTKA

Business Name

EDWIN THADDEUS KAPUSTKA

Original Issue Date

08/19/1952

Effective Date

08/19/1952

Expiration Date

09/30/1998

City

NILES

State

Zip

60714

County

COOK

Ever Disciplined

LastModifiedDate

10/12/2005