PETER EDWARD BLAZEK DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019016456

License Status

NOT RENEWED

Business

First Name

PETER EDWARD

Last Name

BLAZEK

Suffix

DDS

Business Name

PETER EDWARD BLAZEK DDS

Original Issue Date

07/18/1978

Effective Date

06/12/2015

Expiration Date

09/30/2018

City

DARIEN

State

Zip

60561

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/31/2018