TERRY T DINGBAUM 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

TERRY T

Last Name

DINGBAUM

Business Name

TERRY T DINGBAUM

Original Issue Date

11/04/1991

Effective Date

09/24/2015

Expiration Date

09/30/2018

City

MORRIS

State

Zip

60450

County

GRUNDY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018