DALE KONRAD KOSTIWA Dentist License verification

Business Entity

INACTIVE

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021000487

License Status

INACTIVE

Business

First Name

DALE KONRAD

Last Name

KOSTIWA

Business Name

DALE KONRAD KOSTIWA

Original Issue Date

11/23/1965

Effective Date

11/23/1965

Expiration Date

09/30/2002

City

ST CHARLES

State

Zip

60174

County

KANE

Specialty/Qualifier

Orthodontics

Ever Disciplined

LastModifiedDate

10/17/2005