MICHAEL E RISTY DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****68

License Status

CANCELLED

Business

First Name

MICHAEL

Middle

Last Name

RISTY

Suffix

DDS

Business Name

MICHAEL E RISTY DDS

Original Issue Date

03/14/2005

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

PLAINFIELD

State

Zip

60585

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2006