PETER A PAESANI Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****00

License Status

CANCELLED

Business

First Name

PETER A

Last Name

PAESANI

Business Name

PETER A PAESANI

Original Issue Date

01/01/1998

Expiration Date

09/30/2004

City

ROCKFORD

State

Zip

61107

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005