GERALD AWADZI DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****18

License Status

NOT RENEWED

Business

First Name

GERALD

Last Name

AWADZI

Suffix

DMD

Business Name

GERALD AWADZI DMD

Original Issue Date

05/01/2003

Effective Date

08/20/2009

Expiration Date

09/30/2012

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012