MARK A KOLOZENSKI DDS Dentist License verification

MARK A KOLOZENSKI DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000351

License Status

NOT RENEWED

Business

First Name

MARK A

Last Name

KOLOZENSKI

Suffix

DDS

Business Name

MARK A KOLOZENSKI DDS

Original Issue Date

03/15/1994

Effective Date

08/31/2009

Expiration Date

09/30/2012

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

LastModifiedDate

11/19/2012

Case Number

2002007174

Action

Revocation

Discipline Start Date

11/13/2012

Discipline Reason

conscious sedation permit revoked in connection with a 2002 matter relating to the supervision of a patient undergoing conscious sedation and fined in connection with a 2002 matter relating to the supervision of a patient undergoing conscious sedation.