FRED PETER BIASIELLO DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****04

License Status

NOT RENEWED

Business

First Name

FRED

Middle

PETER

Last Name

BIASIELLO

Suffix

DDS

Business Name

FRED PETER BIASIELLO DDS

Original Issue Date

07/13/2009

Effective Date

10/13/2021

Expiration Date

09/30/2024

City

LIBERTYVILLE

State

Zip

60048

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025