LEO PAUL KRUSACK DDS 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

LEO PAUL

Last Name

KRUSACK

Suffix

DDS

Business Name

LEO PAUL KRUSACK DDS

Original Issue Date

01/01/1998

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

GLEN ELLYN

State

Zip

60137

County

DUPAGE

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

11/04/2009