ROBERT JAN BAZAN DDS - Dentist License in Illinois | # 019017925

ROBERT JAN BAZAN DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST

License Number

019017925

License Status

NOT RENEWED

Business

N

Title

DDS

First Name

ROBERT

Middle

JAN

Last Name

BAZAN

Business Name

ROBERT JAN BAZAN DDS

Original Issue Date

10/14/1981

Effective Date

12/21/2015

Expiration Date

09/30/2018

State

IL

Ever Disciplined

N

LastModifiedDate

10/31/2018