ROBERT S GROSELAK Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****94

License Status

CANCELLED

Business

First Name

ROBERT S

Last Name

GROSELAK

Business Name

ROBERT S GROSELAK

Original Issue Date

01/01/1998

Expiration Date

09/30/2002

City

LEMONT

State

Zip

60439

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005