DAVID DOMINIC VI FERNITZ Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****99

License Status

NOT RENEWED

Business

First Name

DAVID DOMINIC VI

Last Name

FERNITZ

Business Name

DAVID DOMINIC VI FERNITZ

Original Issue Date

09/18/1984

Effective Date

09/27/2021

Expiration Date

09/30/2024

City

NORTHBROOK

State

Zip

60062

County

COOK

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

02/04/2025