CHAD R WIERSEMA DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****28

License Status

ACTIVE

Business

First Name

CHAD

Middle

Last Name

WIERSEMA

Suffix

DDS

Business Name

CHAD R WIERSEMA DDS

Original Issue Date

08/21/2003

Effective Date

09/25/2024

Expiration Date

09/30/2027

City

HOMEWOOD

State

Zip

60430

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/25/2024