TODD V MIESEL DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****65

License Status

NOT RENEWED

Business

First Name

TODD V

Last Name

MIESEL

Suffix

DDS

Business Name

TODD V MIESEL DDS

Original Issue Date

11/04/1996

Effective Date

11/04/1996

Expiration Date

09/30/1998

City

GURNEE

State

Zip

60031

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005