GERALD PATRICK WILDMAN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****69

License Status

NOT RENEWED

Business

First Name

GERALD PATRICK

Last Name

WILDMAN

Business Name

GERALD PATRICK WILDMAN

Original Issue Date

08/08/1985

Effective Date

08/08/1985

Expiration Date

09/30/1986

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005