SCOTT W PODLESH 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

SCOTT W

Last Name

PODLESH

Suffix

DDS

Business Name

SCOTT W PODLESH DDS

Original Issue Date

03/18/1994

Effective Date

03/18/1994

Expiration Date

09/30/1996

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005