DANIEL GEORGE ELLENZ DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****59

License Status

NOT RENEWED

Business

First Name

DANIEL GEORGE

Last Name

ELLENZ

Suffix

DDS

Business Name

DANIEL GEORGE ELLENZ DDS

Original Issue Date

11/04/1981

Effective Date

11/04/1981

Expiration Date

09/30/1996

City

LACROSSE

State

Zip

54601

County

WISCONSIN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005