WALTER B OSIKA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****91

License Status

NOT RENEWED

Business

First Name

WALTER B

Last Name

OSIKA

Business Name

WALTER B OSIKA

Original Issue Date

06/24/1992

Effective Date

09/18/2015

Expiration Date

09/30/2018

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018