MARYLENE VITIELLO - Dentist License in Illinois | # 137000602

MARYLENE VITIELLO

Business Entity

ACTIVE

License Type

Dentist

Description

DENTAL SEDATION PERMIT

License Number

137000602

License Status

ACTIVE

Business

N

First Name

MARYLENE

Last Name

VITIELLO

Business Name

MARYLENE VITIELLO

Original Issue Date

10/20/2003

Effective Date

05/15/2024

Expiration Date

09/30/2027

State

IL

Specialty/Qualifier

Conscious Sedation, Parenteral

Ever Disciplined

N

LastModifiedDate

05/15/2024