WILLIAM FANIZZO Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****09

License Status

NOT RENEWED

Business

First Name

WILLIAM

Last Name

FANIZZO

Business Name

WILLIAM FANIZZO

Original Issue Date

01/01/1998

Expiration Date

09/30/1992

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005