THOMAS BLAISE WEIGAND DDS 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

THOMAS BLAISE

Last Name

WEIGAND

Suffix

DDS

Business Name

THOMAS BLAISE WEIGAND DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1996

City

WILLOW SPRINGS

State

Zip

60480

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005