MARTHA E DIAZ DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****84

License Status

ACTIVE

Business

First Name

MARTHA

Middle

Last Name

DIAZ

Suffix

DDS

Business Name

MARTHA E DIAZ DDS

Original Issue Date

12/02/2004

Effective Date

09/04/2024

Expiration Date

09/30/2027

City

WAUKEGAN

State

Zip

60085

County

LAKE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/04/2024