EDWIN THADDEUS KAPUSTKA - Dentist License in Illinois | # 019010130

EDWIN THADDEUS KAPUSTKA

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019010130

License Status

NOT RENEWED

Business

N

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

State

IL

Ever Disciplined

N

LastModifiedDate

10/12/2005