FREDERICK WILLIA LINDBLOM DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****77

License Status

CANCELLED

Business

First Name

FREDERICK WILLIA

Last Name

LINDBLOM

Suffix

DDS

Business Name

FREDERICK WILLIA LINDBLOM DDS

Original Issue Date

01/01/1998

Expiration Date

06/01/1982

City

FOREST PARK

State

Zip

60130

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005