DAVID LEE BOTSKO DMD Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****54

License Status

CANCELLED

Business

First Name

DAVID LEE

Last Name

BOTSKO

Suffix

DMD

Business Name

DAVID LEE BOTSKO DMD

Original Issue Date

01/01/1998

Expiration Date

06/01/1982

City

WOOD RIVER

State

Zip

62095

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005