JACQUELINE DZIERZAK - Dentist License in Illinois | # 019015145

JACQUELINE DZIERZAK

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019015145

License Status

NOT RENEWED

Business

N

First Name

JACQUELINE

Last Name

DZIERZAK

Business Name

JACQUELINE DZIERZAK

Original Issue Date

07/10/1975

Effective Date

07/10/1975

Expiration Date

09/30/2002

State

IL

Ever Disciplined

N

LastModifiedDate

10/17/2005