SCOTT MICHAEL BIETSCH DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****02

License Status

ACTIVE

Business

Title

DMD

First Name

SCOTT

Middle

MICHAEL

Last Name

BIETSCH

Business Name

SCOTT MICHAEL BIETSCH DMD

Original Issue Date

07/06/2010

Effective Date

08/26/2024

Expiration Date

09/30/2027

City

CARBONDALE

State

Zip

62901

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/26/2024