SUZY AZALEA DMD - Dentist License in Illinois | # 137000786

SUZY AZALEA DMD

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000786

License Status

NOT RENEWED

Business

N

First Name

SUZY

Last Name

AZALEA

Suffix

DMD

Business Name

SUZY AZALEA DMD

Original Issue Date

06/24/2010

Effective Date

06/24/2010

Expiration Date

09/30/2012

State

IL

Specialty/Qualifier

DEEP SEDATION AND GENERAL ANESTHESIA

Ever Disciplined

N

LastModifiedDate

11/14/2012