MARY E HETSKO DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****84

License Status

CANCELLED

Business

First Name

MARY

Middle

Last Name

HETSKO

Suffix

DDS

Business Name

MARY E HETSKO DDS

Original Issue Date

02/21/2003

Effective Date

02/21/2003

Expiration Date

09/30/2004

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005