DANIEL M FIDANZE Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****45

License Status

NOT RENEWED

Business

First Name

DANIEL M

Last Name

FIDANZE

Business Name

DANIEL M FIDANZE

Original Issue Date

11/16/1984

Effective Date

11/16/1984

Expiration Date

09/30/1988

City

EVANSTON

State

Zip

60202

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005