KONSTANTIN BORIS MALTSEN DDS 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

KONSTANTIN

Middle

BORIS

Last Name

MALTSEN

Suffix

DDS

Business Name

KONSTANTIN BORIS MALTSEN DDS

Original Issue Date

08/24/1998

Effective Date

08/24/1998

Expiration Date

09/30/2000

City

CHICAGO

State

Zip

60617

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005