ROBERTO ANTONIO DEPAZ Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****01

License Status

NOT RENEWED

Business

First Name

ROBERTO ANTONIO

Last Name

DEPAZ

Business Name

ROBERTO ANTONIO DEPAZ

Original Issue Date

03/12/1984

Effective Date

03/12/1984

Expiration Date

09/30/2006

City

CHICAGO HEIGHTS

State

Zip

60411

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006