EDWARD MATTHEW WYDRA DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****55

License Status

CANCELLED

Business

First Name

EDWARD

Middle

MATTHEW

Last Name

WYDRA

Suffix

DDS

Business Name

EDWARD MATTHEW WYDRA DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2006

City

PALOS PARK

State

Zip

60464

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

07/24/2006