AGATHA N DZIEDZIECH DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019026258

License Status

ACTIVE

Business

First Name

AGATHA

Middle

Last Name

DZIEDZIECH

Suffix

DDS

Business Name

AGATHA N DZIEDZIECH DDS

Original Issue Date

09/05/2003

Effective Date

09/22/2024

Expiration Date

09/30/2027

City

SCOTTSDALE

State

Zip

85255

Ever Disciplined

LastModifiedDate

09/22/2024

Case Number

2024003994

Action

Suspension

Discipline Start Date

07/15/2024

Discipline End Date

02/26/2025

Discipline Reason

Failure to file and/or pay Illinois state income taxes. Notice of tax deficiency release received from Department of Revenue on 02/27/2025.