S RICHARD BOSACK 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

S RICHARD

Last Name

BOSACK

Business Name

S RICHARD BOSACK

Original Issue Date

01/01/1998

Expiration Date

09/30/1992

City

EVERGREEN PARK

State

Zip

60642

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005