GRANT ANDERSON PIZZO Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****58

License Status

NOT RENEWED

Business

First Name

GRANT

Middle

ANDERSON

Last Name

PIZZO

Business Name

GRANT ANDERSON PIZZO

Original Issue Date

06/18/2018

Effective Date

06/18/2018

Expiration Date

01/31/2022

City

INDIAN HEAD PARK

State

Zip

60525

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022