TED C BLECKSTEIN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****33

License Status

NOT RENEWED

Business

First Name

TED C

Last Name

BLECKSTEIN

Suffix

DDS

Business Name

TED C BLECKSTEIN DDS

Original Issue Date

09/24/1987

Effective Date

09/24/1987

Expiration Date

09/30/1992

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005