ROBERT JAN BAZAN DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****15

License Status

NOT RENEWED

Business

Title

DDS

First Name

ROBERT

Middle

JAN

Last Name

BAZAN

Business Name

ROBERT JAN BAZAN DDS

Original Issue Date

10/23/1981

Effective Date

06/08/2015

Expiration Date

09/30/2018

City

HANOVER PARK

State

Zip

60133

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018