STACI L BLAZENIAK - Dentist License in Illinois | # 020015217

STACI L BLAZENIAK

Business Entity

ACTIVE

License Type

Dentist

Description

REGISTERED DENTAL HYGIENIST

License Number

020015217

License Status

ACTIVE

Business

N

First Name

STACI

Middle

L

Last Name

BLAZENIAK

Business Name

STACI L BLAZENIAK

Original Issue Date

08/04/2015

Effective Date

09/05/2024

Expiration Date

09/30/2027

State

IL

Ever Disciplined

N

LastModifiedDate

09/05/2024