PETER CARL WASILKOFF DDS 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

PETER CARL

Last Name

WASILKOFF

Suffix

DDS

Business Name

PETER CARL WASILKOFF DDS

Original Issue Date

10/20/1992

Effective Date

10/20/1992

Expiration Date

09/30/1996

City

CALUMET CITY

State

Zip

60409

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005