SRDJAN ILIC-SILJAK DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****18

License Status

NOT RENEWED

Business

First Name

SRDJAN

Last Name

ILIC-SILJAK

Suffix

DMD

Business Name

SRDJAN ILIC-SILJAK DMD

Original Issue Date

07/28/2005

Effective Date

06/04/2009

Expiration Date

09/30/2012

City

QUINCY

State

Zip

62301

County

ADAMS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012