PETER RAY WILDMAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****28

License Status

NOT RENEWED

Business

First Name

PETER RAY

Last Name

WILDMAN

Business Name

PETER RAY WILDMAN

Original Issue Date

01/19/1984

Effective Date

01/19/1984

Expiration Date

09/30/1984

City

CHICAGO

State

Zip

60624

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005