DONALD A KRZYZAK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****21

License Status

NOT RENEWED

Business

First Name

DONALD A

Last Name

KRZYZAK

Business Name

DONALD A KRZYZAK

Original Issue Date

01/01/1998

Expiration Date

09/30/1996

City

MOUNT PROSPECT

State

Zip

60056

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005