KEITH JOHN GAZDA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****56

License Status

NOT RENEWED

Business

First Name

KEITH JOHN

Last Name

GAZDA

Business Name

KEITH JOHN GAZDA

Original Issue Date

07/25/1985

Effective Date

07/25/1985

Expiration Date

09/30/1994

City

NAPERVILLE

State

Zip

60563

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005