LEO PAUL KRUSACK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019014094

License Status

NOT RENEWED

Business

First Name

LEO PAUL

Last Name

KRUSACK

Suffix

DDS

Business Name

LEO PAUL KRUSACK DDS

Original Issue Date

07/08/1971

Effective Date

10/01/2006

Expiration Date

09/30/2009

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Ever Disciplined

LastModifiedDate

01/08/2010