JEROME MICHAEL COLLETTI DDS Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000104

License Status

CANCELLED

Business

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

City

SUGAR GROVE

State

Zip

60554

County

KANE

Specialty/Qualifier

Deep Sedation and General Anesthesia

Ever Disciplined

LastModifiedDate

06/04/2009