NICHOLAS A VINCENZO Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****08

License Status

NOT RENEWED

Business

First Name

NICHOLAS A

Last Name

VINCENZO

Business Name

NICHOLAS A VINCENZO

Original Issue Date

09/21/1984

Effective Date

09/21/1984

Expiration Date

09/30/1986

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005