DAVID RICHARD BISTERFELDT DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****36

License Status

NOT RENEWED

Business

Title

DDS

First Name

DAVID

Middle

RICHARD

Last Name

BISTERFELDT

Business Name

DAVID RICHARD BISTERFELDT DDS

Original Issue Date

06/08/2010

Effective Date

12/07/2021

Expiration Date

09/30/2024

City

CHICAGO

State

Zip

60602

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025