DANIEL JOSEPH MARTISIUS DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****73

License Status

NOT RENEWED

Business

First Name

DANIEL JOSEPH

Last Name

MARTISIUS

Suffix

DDS

Business Name

DANIEL JOSEPH MARTISIUS DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/2004

City

ELK GROVE VILLAGE

State

Zip

60007

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005