MARY L FITZPATRICK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****21

License Status

NOT RENEWED

Business

First Name

MARY L

Last Name

FITZPATRICK

Business Name

MARY L FITZPATRICK

Original Issue Date

08/13/1986

Effective Date

08/13/1986

Expiration Date

09/30/1990

City

DURAND

State

Zip

61024

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005