JONAS T AVIZA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****83

License Status

NOT RENEWED

Business

First Name

JONAS T

Last Name

AVIZA

Business Name

JONAS T AVIZA

Original Issue Date

07/13/1983

Effective Date

07/13/1983

Expiration Date

09/30/1984

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005