THOMAS J BALAZS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000816

License Status

NOT RENEWED

Business

First Name

THOMAS J

Last Name

BALAZS

Business Name

THOMAS J BALAZS

Original Issue Date

09/20/1994

Effective Date

09/20/1994

Expiration Date

06/30/1995

City

EVANSTON

State

Zip

60201

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005