BLAINE PATRICK CUSACK - Dentist License in Illinois | # 019019211

BLAINE PATRICK CUSACK

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019019211

License Status

NOT RENEWED

Business

N

First Name

BLAINE

Middle

PATRICK

Last Name

CUSACK

Business Name

BLAINE PATRICK CUSACK

Original Issue Date

08/16/1984

Effective Date

11/10/2021

Expiration Date

09/30/2024

State

IL

Ever Disciplined

Y

LastModifiedDate

02/04/2025

Case Number

1991004993

Action

Probation

Discipline Start Date

09/17/1994

Discipline End Date

09/16/1996

Discipline Reason

Aleged multiple violations of the Illinois Dental Practice Act.