PHILIP M MONTEFALCO DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018000344

License Status

NOT RENEWED

Business

First Name

PHILIP M

Last Name

MONTEFALCO

Suffix

DDS

Business Name

PHILIP M MONTEFALCO DDS

Original Issue Date

06/07/1989

Effective Date

06/07/1989

Expiration Date

06/30/1990

City

CHICAGO

State

Zip

60616

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

10/12/2005