HENRY J DIETTRICH JR DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****37

License Status

CANCELLED

Business

First Name

HENRY

Middle

Last Name

DIETTRICH

Suffix

JR DDS

Business Name

HENRY J DIETTRICH JR DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2002

City

GLENCOE

State

Zip

60022

County

COOK

Controlled Substance Schedule

III

Ever Disciplined

LastModifiedDate

10/17/2005