ERNEST LAWRENCE DIETL JR DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****78

License Status

NOT RENEWED

Business

First Name

ERNEST LAWRENCE

Last Name

DIETL JR

Suffix

DDS

Business Name

ERNEST LAWRENCE DIETL JR DDS

Original Issue Date

01/01/1998

Effective Date

09/19/2012

Expiration Date

09/30/2015

City

PARK FOREST

State

Zip

60466

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016