BETHELEN O PUDIK Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****11

License Status

ACTIVE

Business

First Name

BETHELEN O

Last Name

PUDIK

Business Name

BETHELEN O PUDIK

Original Issue Date

01/09/1995

Effective Date

09/20/2024

Expiration Date

09/30/2027

City

PEORIA

State

Zip

61615

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/20/2024