SAM MICHAEL CICCARELLI DDS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST

License Number

019015534

License Status

ACTIVE

Business

First Name

SAM MICHAEL

Last Name

CICCARELLI

Suffix

DDS

Business Name

SAM MICHAEL CICCARELLI DDS

Original Issue Date

07/13/1976

Effective Date

05/01/2024

Expiration Date

09/30/2027

City

CHICAGO

State

Zip

60631

County

COOK

Ever Disciplined

LastModifiedDate

05/01/2024

Case Number

2014011088

Action

Suspension

Discipline Start Date

02/13/2015

Discipline End Date

06/07/2017

Discipline Reason

Failure to file and/or pay Illinois state income taxes. Notice of tax deficiency release received from Department of Revenue on 06/08/2017.