STANLEY JEROME WITKIEWICZ DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****27

License Status

NOT RENEWED

Business

First Name

STANLEY JEROME

Last Name

WITKIEWICZ

Suffix

DDS

Business Name

STANLEY JEROME WITKIEWICZ DDS

Original Issue Date

01/01/1998

Effective Date

09/28/2009

Expiration Date

09/30/2012

City

ANTIOCH

State

Zip

60002

County

LAKE

Controlled Substance Schedule

III IV

Ever Disciplined

LastModifiedDate

11/14/2012