LYUDMILA ROMANOVNA TAVOLZHANSKAYA Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****63

License Status

ACTIVE

Business

First Name

LYUDMILA

Middle

ROMANOVNA

Last Name

TAVOLZHANSKAYA

Business Name

LYUDMILA ROMANOVNA TAVOLZHANSKAYA

Original Issue Date

07/20/2006

Effective Date

09/19/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60641

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

09/19/2024