CHARLES STANLEY CZEREPAK DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000465

License Status

ACTIVE

Business

First Name

CHARLES

Middle

STANLEY

Last Name

CZEREPAK

Suffix

DMD

Business Name

CHARLES STANLEY CZEREPAK DMD

Original Issue Date

08/04/1999

Effective Date

07/08/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60642

County

COOK

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

LastModifiedDate

07/08/2024