KEVIN T LADESIC Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****01

License Status

NOT RENEWED

Business

First Name

KEVIN

Middle

Last Name

LADESIC

Business Name

KEVIN T LADESIC

Original Issue Date

11/16/2012

Effective Date

12/22/2021

Expiration Date

09/30/2024

City

OSHKOSH

State

Zip

54901

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/04/2025