LARRY ALLAN CRISAFULLI DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****12

License Status

NOT RENEWED

Business

First Name

LARRY ALLAN

Last Name

CRISAFULLI

Suffix

DDS

Business Name

LARRY ALLAN CRISAFULLI DDS

Original Issue Date

01/01/1998

Expiration Date

09/30/1996

City

LINCOLN

State

Zip

62656

County

LOGAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005