GLENN FREDERICK EDMISTON III DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****81

License Status

NOT RENEWED

Business

First Name

GLENN FREDERICK

Last Name

EDMISTON III

Suffix

DDS

Business Name

GLENN FREDERICK EDMISTON III DDS

Original Issue Date

01/01/1998

Effective Date

08/03/2012

Expiration Date

09/30/2015

City

SHOREWOOD

State

Zip

60404

County

WILL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016