RANDAL MARK KOWALSKE Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****72

License Status

ACTIVE

Business

First Name

RANDAL MARK

Last Name

KOWALSKE

Business Name

RANDAL MARK KOWALSKE

Original Issue Date

01/01/1998

Effective Date

09/26/2024

Expiration Date

09/30/2027

City

PEORIA

State

Zip

61604

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2024