SUSAN TERESA STAKIW Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

RESTRICTED FACULTY LICENSE

License Number

136000078

License Status

EXPIRED

Business

First Name

SUSAN

Middle

TERESA

Last Name

STAKIW

Business Name

SUSAN TERESA STAKIW

Original Issue Date

08/07/2001

Effective Date

08/07/2001

Expiration Date

08/19/2006

City

NAPERVILLE

State

Zip

60563

County

DUPAGE

Ever Disciplined

LastModifiedDate

11/03/2006