MICHAELLA RADICH HEITZLER DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****93

License Status

NOT RENEWED

Business

Title

DMD

First Name

MICHAELLA

Middle

RADICH

Last Name

HEITZLER

Business Name

MICHAELLA RADICH HEITZLER DMD

Original Issue Date

07/17/2014

Effective Date

06/16/2015

Expiration Date

09/30/2018

City

CHICAGO

State

Zip

60622

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018