GLENN R GROSELAK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****13

License Status

NOT RENEWED

Business

First Name

GLENN

Middle

Last Name

GROSELAK

Suffix

DDS

Business Name

GLENN R GROSELAK DDS

Original Issue Date

01/26/1989

Effective Date

10/23/2009

Expiration Date

09/30/2012

City

LEMONT

State

Zip

60439

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012