PHILIP RICHARD FRYSTAK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****83

License Status

NOT RENEWED

Business

First Name

PHILIP RICHARD

Last Name

FRYSTAK

Business Name

PHILIP RICHARD FRYSTAK

Original Issue Date

10/11/1984

Effective Date

12/09/2021

Expiration Date

09/30/2024

City

ROSELLE

State

Zip

60172

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025