MICHELLE SARAH MODAFF DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****03

License Status

NOT RENEWED

Business

First Name

MICHELLE

Middle

SARAH

Last Name

MODAFF

Suffix

DDS

Business Name

MICHELLE SARAH MODAFF DDS

Original Issue Date

07/17/2000

Effective Date

09/28/2009

Expiration Date

09/30/2012

City

AURORA

State

Zip

60504

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/14/2012