RICHARD MARK JANICZEK Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****49

License Status

NOT RENEWED

Business

First Name

RICHARD MARK

Last Name

JANICZEK

Business Name

RICHARD MARK JANICZEK

Original Issue Date

09/24/1981

Effective Date

10/02/2012

Expiration Date

09/30/2015

City

CHICAGO RIDGE

State

Zip

60415

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016