AGNES DZIARSKI Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****89

License Status

NOT RENEWED

Business

First Name

AGNES

Last Name

DZIARSKI

Business Name

AGNES DZIARSKI

Original Issue Date

12/05/1986

Effective Date

12/05/1986

Expiration Date

09/30/1988

City

CALUMET CITY

State

Zip

60409

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/29/2007

Case Number

2003007831

Action

Suspension

Discipline Start Date

08/03/2004

Discipline End Date

09/28/2007

Discipline Reason

Dispensed controlled substances for other than therapeutic purposes.