GEOFFREY R WARDA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****20

License Status

NOT RENEWED

Business

First Name

GEOFFREY R

Last Name

WARDA

Business Name

GEOFFREY R WARDA

Original Issue Date

02/04/1998

Effective Date

02/04/1998

Expiration Date

09/30/1998

City

GREAT LAKES

State

Zip

60088

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005