KONSTANTIN BORIS MALTSEN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****05

License Status

NOT RENEWED

Business

First Name

KONSTANTIN

Middle

BORIS

Last Name

MALTSEN

Suffix

DDS

Business Name

KONSTANTIN BORIS MALTSEN DDS

Original Issue Date

03/15/1999

Effective Date

03/15/1999

Expiration Date

09/30/2000

City

WHEELING

State

Zip

60090

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005