LIDIA WASIAK DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****31

License Status

NOT RENEWED

Business

First Name

LIDIA

Last Name

WASIAK

Suffix

DMD

Business Name

LIDIA WASIAK DMD

Original Issue Date

06/18/1998

Effective Date

06/18/1998

Expiration Date

09/30/2006

City

MOUNT PROSPECT

State

Zip

60056

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/08/2006