PATRICK MICHAEL CUSACK DMD Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****04

License Status

ACTIVE

Business

First Name

PATRICK MICHAEL

Last Name

CUSACK

Suffix

DMD

Business Name

PATRICK MICHAEL CUSACK DMD

Original Issue Date

10/28/1998

Effective Date

08/07/2024

Expiration Date

09/30/2027

City

PEORIA

State

Zip

61614

County

PEORIA

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

08/07/2024