JOSHUA A MONDLICK DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****96

License Status

CANCELLED

Business

First Name

JOSHUA

Middle

Last Name

MONDLICK

Suffix

DDS

Business Name

JOSHUA A MONDLICK DDS

Original Issue Date

06/22/2004

Effective Date

06/22/2004

Expiration Date

09/30/2006

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005