HOLLY J HOUSKA DMD 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

HOLLY J

Last Name

HOUSKA

Suffix

DMD

Business Name

HOLLY J HOUSKA DMD

Original Issue Date

03/10/1989

Effective Date

09/04/2015

Expiration Date

09/30/2018

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018