RICHARD L FIESE 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

RICHARD L

Last Name

FIESE

Business Name

RICHARD L FIESE

Original Issue Date

07/28/1982

Effective Date

07/28/1982

Expiration Date

09/30/1988

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005