GEOFFREY R WARDA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000439

License Status

NOT RENEWED

Business

First Name

GEOFFREY R

Last Name

WARDA

Business Name

GEOFFREY R WARDA

Original Issue Date

03/25/1998

Effective Date

03/25/1998

Expiration Date

09/30/2000

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Specialty/Qualifier

Deep Sedation and General Anesthesia

Ever Disciplined

LastModifiedDate

10/17/2005