ANGELINA FU DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****13

License Status

NOT RENEWED

Business

First Name

ANGELINA

Last Name

Suffix

DMD

Business Name

ANGELINA FU DMD

Original Issue Date

05/05/2005

Effective Date

05/05/2005

Expiration Date

09/30/2006

City

GRANITE CITY

State

Zip

62040

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/16/2007