LEE J CRISANTI Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****05

License Status

NOT RENEWED

Business

First Name

LEE

Middle

Last Name

CRISANTI

Business Name

LEE J CRISANTI

Original Issue Date

09/01/1982

Effective Date

09/01/1982

Expiration Date

09/30/2004

City

CHICAGO

State

Zip

60616

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005