LEE D FILLAK DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****09

License Status

NOT RENEWED

Business

First Name

LEE

Middle

Last Name

FILLAK

Suffix

DMD

Business Name

LEE D FILLAK DMD

Original Issue Date

11/22/1994

Effective Date

11/22/1994

Expiration Date

09/30/1998

City

CALUMET CITY

State

Zip

60409

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005