NICHOLAS W MISISCHIA DMD Dentist License verification

Business Entity

INOPERATIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****50

License Status

INOPERATIVE

Business

First Name

NICHOLAS W

Last Name

MISISCHIA

Suffix

DMD

Business Name

NICHOLAS W MISISCHIA DMD

Original Issue Date

07/07/1997

Effective Date

07/07/1997

Expiration Date

09/30/2002

City

CHICAGO HEIGHTS

State

Zip

60411

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005