ELIZABETH ANN KOSSAK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****48

License Status

NOT RENEWED

Business

First Name

ELIZABETH

Middle

ANN

Last Name

KOSSAK

Business Name

ELIZABETH ANN KOSSAK

Original Issue Date

06/11/2013

Effective Date

06/11/2013

Expiration Date

09/30/2015

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016