TERRY A SELLKE DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****03

License Status

CANCELLED

Business

First Name

TERRY

Middle

Last Name

SELLKE

Suffix

DDS

Business Name

TERRY A SELLKE DDS

Original Issue Date

10/24/1991

Effective Date

10/24/1991

Expiration Date

09/30/1992

City

WAUKEGAN

State

Zip

60087

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005