GERALD WAYNE MALIS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****12

License Status

NOT RENEWED

Business

First Name

GERALD WAYNE

Last Name

MALIS

Suffix

DDS

Business Name

GERALD WAYNE MALIS DDS

Original Issue Date

01/01/1998

Effective Date

08/24/2015

Expiration Date

09/30/2018

City

BUFFALO GROVE

State

Zip

60089

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018