AIDIS S KOZICA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****43

License Status

NOT RENEWED

Business

First Name

AIDIS S

Last Name

KOZICA

Business Name

AIDIS S KOZICA

Original Issue Date

07/19/1988

Effective Date

07/19/1988

Expiration Date

09/30/1990

City

ITASCA

State

Zip

60143

County

DUPAGE

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

10/13/2005