BERTRAM FIVELSON DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****30

License Status

NOT RENEWED

Business

First Name

BERTRAM

Last Name

FIVELSON

Suffix

DDS

Business Name

BERTRAM FIVELSON DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1990

City

HIGHLAND PARK

State

Zip

60035

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005