MICHAEL TED KOSTAL DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****12

License Status

ACTIVE

Business

First Name

MICHAEL

Middle

TED

Last Name

KOSTAL

Suffix

DDS

Business Name

MICHAEL TED KOSTAL DDS

Original Issue Date

11/22/2013

Effective Date

09/23/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60603

County

KENDALL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/23/2024