KONSTANTIN S DZAMASHVILI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

NOT RENEWED

Business

First Name

KONSTANTIN S

Last Name

DZAMASHVILI

Suffix

Business Name

KONSTANTIN S DZAMASHVILI MD

Original Issue Date

08/06/1996

Effective Date

04/11/2014

Expiration Date

07/31/2017

City

WINFIELD

State

Zip

60555

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017