DREW ANTHONY COLANTINO Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****04

License Status

ACTIVE

Business

First Name

DREW

Middle

ANTHONY

Last Name

COLANTINO

Business Name

DREW ANTHONY COLANTINO

Original Issue Date

08/28/2012

Effective Date

05/02/2024

Expiration Date

09/30/2027

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/02/2024