FRANK RAYMOND PETLAK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****62

License Status

NOT RENEWED

Business

First Name

FRANK RAYMOND

Last Name

PETLAK

Suffix

DDS

Business Name

FRANK RAYMOND PETLAK DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2000

City

NILES

State

Zip

60648

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005