JOEL C WIECZOREK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****57

License Status

NOT RENEWED

Business

First Name

JOEL C

Last Name

WIECZOREK

Business Name

JOEL C WIECZOREK

Original Issue Date

11/28/1983

Effective Date

11/28/1983

Expiration Date

09/30/2000

City

CHICAGO RIDGE

State

Zip

60415

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005