DOMINIC E BOFFA DDS - Dentist License in Illinois | # 137000287

DOMINIC E BOFFA DDS

Business Entity

NOT RENEWED

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000287

License Status

NOT RENEWED

Business

N

First Name

DOMINIC

Middle

E

Last Name

BOFFA

Suffix

DDS

Business Name

DOMINIC E BOFFA DDS

Original Issue Date

03/26/1991

Effective Date

07/24/2006

Expiration Date

09/30/2009

State

IL

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

N

LastModifiedDate

11/04/2009