HENRY S BOGACKI Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****55

License Status

NOT RENEWED

Business

First Name

HENRY S

Last Name

BOGACKI

Business Name

HENRY S BOGACKI

Original Issue Date

01/01/1998

Expiration Date

09/30/1988

City

CHICAGO

State

Zip

60641

County

COOK

Controlled Substance Schedule

III

Ever Disciplined

LastModifiedDate

10/13/2005