DAVID FREDERICK MEHLISCH Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****92

License Status

NOT RENEWED

Business

First Name

DAVID FREDERICK

Last Name

MEHLISCH

Business Name

DAVID FREDERICK MEHLISCH

Original Issue Date

04/02/1985

Effective Date

04/02/1985

Expiration Date

09/30/1996

City

EDWARDSVILLE

State

Zip

62025

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005