JEROME MICHAEL COLLETTI DDS - Dentist License in Illinois | # 137000104

JEROME MICHAEL COLLETTI DDS

Business Entity

CANCELLED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000104

License Status

CANCELLED

Business

N

First Name

JEROME MICHAEL

Last Name

COLLETTI

Suffix

DDS

Business Name

JEROME MICHAEL COLLETTI DDS

Original Issue Date

01/01/1998

Effective Date

07/24/2006

Expiration Date

09/30/2009

State

IL

Specialty/Qualifier

Deep Sedation and General Anesthesia

Ever Disciplined

N

LastModifiedDate

06/04/2009