MICHAEL GENE CORREALE DMD 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

MICHAEL GENE

Last Name

CORREALE

Suffix

DMD

Business Name

MICHAEL GENE CORREALE DMD

Original Issue Date

09/28/1984

Effective Date

09/28/1984

Expiration Date

09/30/1992

City

BELLEVILLE

State

Zip

62225

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005