ALBERT A DIEPSTRA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****15

License Status

NOT RENEWED

Business

First Name

ALBERT A

Last Name

DIEPSTRA

Suffix

DDS

Business Name

ALBERT A DIEPSTRA DDS

Original Issue Date

01/01/1998

Effective Date

08/22/2018

Expiration Date

01/31/2022

City

LA GRANGE

State

Zip

60526

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022