ROBERT THEODORE STANUCH DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****54

License Status

CANCELLED

Business

First Name

ROBERT THEODORE

Last Name

STANUCH

Suffix

DDS

Business Name

ROBERT THEODORE STANUCH DDS

Original Issue Date

11/08/1990

Effective Date

11/08/1990

Expiration Date

09/30/1992

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005