EUGENE W PRYSTALSKI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****69

License Status

NOT RENEWED

Business

Title

DDS

First Name

EUGENE

Middle

Last Name

PRYSTALSKI

Business Name

EUGENE W PRYSTALSKI DDS

Original Issue Date

01/01/1998

Effective Date

09/14/2009

Expiration Date

09/30/2012

City

SOUTH HOLLAND

State

Zip

60473

County

COOK

Controlled Substance Schedule

IV V

Ever Disciplined

LastModifiedDate

11/14/2012