DAISY CAROLINA SALAZAR DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****35

License Status

NOT RENEWED

Business

First Name

DAISY

Middle

CAROLINA

Last Name

SALAZAR

Suffix

DDS

Business Name

DAISY CAROLINA SALAZAR DDS

Original Issue Date

04/30/2014

Effective Date

04/30/2014

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PHARM DISTRIBUTOR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016