EZIO EDWARD GROSSI Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****84

License Status

NOT RENEWED

Business

First Name

EZIO EDWARD

Last Name

GROSSI

Business Name

EZIO EDWARD GROSSI

Original Issue Date

11/16/1987

Effective Date

08/19/2009

Expiration Date

09/30/2012

City

FLOSSMOOR

State

Zip

60422

County

COOK

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

11/14/2012