MICHAELLA RADICH HEITZLER DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED SPECIALIST IN DENTISTRY

License Number

021002583

License Status

NOT RENEWED

Business

Title

DMD

First Name

MICHAELLA

Middle

RADICH

Last Name

HEITZLER

Business Name

MICHAELLA RADICH HEITZLER DMD

Original Issue Date

07/31/2014

Effective Date

06/16/2015

Expiration Date

09/30/2018

City

CHICAGO

State

Zip

60647

County

WISCONSIN

Specialty/Qualifier

PEDIATRIC DENTISTRY

Ever Disciplined

LastModifiedDate

10/31/2018