F JERALD NUSTRA DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****88

License Status

NOT RENEWED

Business

First Name

F JERALD

Last Name

NUSTRA

Suffix

DDS

Business Name

F JERALD NUSTRA DDS

Original Issue Date

01/01/1998

Effective Date

10/02/2009

Expiration Date

09/30/2012

City

MCHENRY

State

Zip

60050

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012