WAYNE BENNETT LAPETODA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****50

License Status

NOT RENEWED

Business

First Name

WAYNE BENNETT

Last Name

LAPETODA

Business Name

WAYNE BENNETT LAPETODA

Original Issue Date

05/11/1982

Effective Date

05/11/1982

Expiration Date

09/30/1984

City

GAGES LAKE

State

Zip

60030

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005