CARYN MARIE BALSEWICH DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****37

License Status

NOT RENEWED

Business

First Name

CARYN

Middle

MARIE

Last Name

BALSEWICH

Suffix

DDS

Business Name

CARYN MARIE BALSEWICH DDS

Original Issue Date

04/19/2000

Effective Date

04/19/2000

Expiration Date

09/30/2002

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005