MARY S FAZIO Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020004492

License Status

NOT RENEWED

Business

First Name

MARY

Middle

Last Name

FAZIO

Business Name

MARY S FAZIO

Original Issue Date

06/25/1981

Effective Date

06/25/1981

Expiration Date

09/30/1996

City

DARIEN

State

Zip

60561

County

DUPAGE

Ever Disciplined

LastModifiedDate

10/12/2005