MARITA K JANZEN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****02

License Status

NOT RENEWED

Business

First Name

MARITA K

Last Name

JANZEN

Business Name

MARITA K JANZEN

Original Issue Date

06/09/1992

Effective Date

06/09/1992

Expiration Date

09/30/1996

City

NORTHBROOK

State

Zip

60062

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005