RICHARD C MAZANEK Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****28

License Status

ACTIVE

Business

First Name

RICHARD C

Last Name

MAZANEK

Business Name

RICHARD C MAZANEK

Original Issue Date

08/02/1983

Effective Date

05/09/2024

Expiration Date

09/30/2027

City

NILES

State

Zip

60714

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2024