THOMAS C SIEWERT Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****79

License Status

NOT RENEWED

Business

First Name

THOMAS C

Last Name

SIEWERT

Business Name

THOMAS C SIEWERT

Original Issue Date

01/01/1998

Effective Date

07/24/2006

Expiration Date

09/30/2009

City

SOUTH ELGIN

State

Zip

60177

County

KANE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009