JOHN WILLIAM POLIVKA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****87

License Status

NOT RENEWED

Business

Title

DDS

First Name

JOHN

Middle

WILLIAM

Last Name

POLIVKA

Business Name

JOHN WILLIAM POLIVKA DDS

Original Issue Date

07/26/2013

Effective Date

10/03/2021

Expiration Date

09/30/2024

City

LA GRANGE

State

Zip

60525

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025