DAVID JOHN WICKS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****76

License Status

NOT RENEWED

Business

First Name

DAVID JOHN

Last Name

WICKS

Business Name

DAVID JOHN WICKS

Original Issue Date

12/05/1983

Effective Date

12/05/1983

Expiration Date

09/30/1986

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005