THOMAS PETER FIORENZA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****72

License Status

NOT RENEWED

Business

First Name

THOMAS

Middle

PETER

Last Name

FIORENZA

Business Name

THOMAS PETER FIORENZA

Original Issue Date

08/18/1989

Effective Date

12/10/2012

Expiration Date

09/30/2015

City

ORLAND PARK

State

Zip

60462

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/08/2016