JERRY W KOLESAR DMD 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

JERRY W

Last Name

KOLESAR

Suffix

DMD

Business Name

JERRY W KOLESAR DMD

Original Issue Date

10/17/1988

Effective Date

10/17/1988

Expiration Date

09/30/1990

City

GRANITE CITY

State

Zip

62040

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005