CLEMENT RICHARD JASIEK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****56

License Status

NOT RENEWED

Business

First Name

CLEMENT RICHARD

Last Name

JASIEK

Suffix

DDS

Business Name

CLEMENT RICHARD JASIEK DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1994

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

10/13/2005