LOIDA TICZON PREZA Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****94

License Status

NOT RENEWED

Business

First Name

LOIDA TICZON

Last Name

PREZA

Business Name

LOIDA TICZON PREZA

Original Issue Date

09/16/1992

Effective Date

09/29/2015

Expiration Date

09/30/2018

City

CHICAGO

State

Zip

60625

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/31/2018