WILLIAM KARL VANDERWAAL 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

WILLIAM KARL

Last Name

VANDERWAAL

Suffix

DDS

Business Name

WILLIAM KARL VANDERWAAL DDS

Original Issue Date

08/21/1990

Effective Date

08/21/1990

Expiration Date

09/30/2000

City

STREATOR

State

Zip

61364

County

LA SALLE

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

10/17/2005