KENNETH J BODNAR Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****95

License Status

NOT RENEWED

Business

First Name

KENNETH J

Last Name

BODNAR

Business Name

KENNETH J BODNAR

Original Issue Date

08/04/1982

Effective Date

08/04/1982

Expiration Date

09/30/1984

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005