GRACE A DZIDO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

ACTIVE

Business

First Name

GRACE

Middle

Last Name

DZIDO

Business Name

GRACE A DZIDO

Original Issue Date

01/28/2004

Effective Date

04/15/2023

Expiration Date

07/31/2026

City

STICKNEY

State

Zip

60402

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/15/2023