DANIEL K MARTISIUS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****26

License Status

NOT RENEWED

Business

First Name

DANIEL K

Last Name

MARTISIUS

Business Name

DANIEL K MARTISIUS

Original Issue Date

10/15/1987

Effective Date

10/15/1987

Expiration Date

09/30/1996

City

PALATINE

State

Zip

60067

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005