DOUGLAS OWEN WEIDMAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****49

License Status

NOT RENEWED

Business

First Name

DOUGLAS OWEN

Last Name

WEIDMAN

Business Name

DOUGLAS OWEN WEIDMAN

Original Issue Date

01/01/1998

Effective Date

08/03/2015

Expiration Date

09/30/2018

City

SKOKIE

State

Zip

60077

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018