PHILIP R FARRUGGIA DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****07

License Status

NOT RENEWED

Business

First Name

PHILIP R

Last Name

FARRUGGIA

Suffix

DMD

Business Name

PHILIP R FARRUGGIA DMD

Original Issue Date

03/20/1990

Effective Date

03/20/1990

Expiration Date

09/30/1996

City

GRANITE CITY

State

Zip

62040

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005