PATRICIA MARGARET WALTZ DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****01

License Status

NOT RENEWED

Business

Title

DMD

First Name

PATRICIA

Middle

MARGARET

Last Name

WALTZ

Business Name

PATRICIA MARGARET WALTZ DMD

Original Issue Date

08/25/2022

Effective Date

08/25/2022

Expiration Date

09/30/2024

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025