RONALD C MYCZEK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****45

License Status

NOT RENEWED

Business

First Name

RONALD C

Last Name

MYCZEK

Suffix

DDS

Business Name

RONALD C MYCZEK DDS

Original Issue Date

08/01/1983

Effective Date

09/04/2012

Expiration Date

09/30/2015

City

ORLAND PARK

State

Zip

60462

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016