WAYNE R ERICKSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****17

License Status

NOT RENEWED

Business

First Name

WAYNE R

Last Name

ERICKSON

Suffix

DDS

Business Name

WAYNE R ERICKSON DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1996

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005