THOMAS A WIESE Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****81

License Status

ACTIVE

Business

First Name

THOMAS A

Last Name

WIESE

Business Name

THOMAS A WIESE

Original Issue Date

12/06/1989

Effective Date

08/13/2024

Expiration Date

09/30/2027

City

SOUTH HOLLAND

State

Zip

60473

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/13/2024