JOAN BAZIOTES DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****96

License Status

NOT RENEWED

Business

First Name

JOAN

Last Name

BAZIOTES

Suffix

DDS

Business Name

JOAN BAZIOTES DDS

Original Issue Date

10/30/1989

Effective Date

10/30/1989

Expiration Date

09/30/2004

City

LINCOLNWOOD

State

Zip

60712

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005